Open AccessGeneralised peritonitis from strangulated small bowel obstruction secondary to mesh erosion: a rare long-term complication of laparoscopic mesh sacrohysteropexy
Author(s) -
Constantinos Simillis,
Olivia James,
Kiranpreet Gill,
Yimeng Zhang
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-226309
Subject(s) - medicine , bowel obstruction , laparotomy , surgery , anastomosis , perforation , laparoscopy , bowel perforation , bowel resection , peritonitis , complication , general surgery , materials science , punching , metallurgy
A 77-year-old woman who underwent an uncomplicated laparoscopic mesh sacrohysteropexy (LMH) in 2009 for uterovaginal prolapse, presented with features of small bowel obstruction (SBO) 9 years later. She underwent laparotomy which revealed that the sacrohysteropexy mesh had eroded into the small bowel causing complete obstruction, complicated by ischaemia and perforation. Small bowel resection and primary anastomosis was performed, and the patient had an uneventful postoperative recovery. Although rare, cases of SBO occurring secondary to the use of a synthetic mesh in LMH have been reported. This is the first reported case of SBO directly attributable to erosion of mesh into the small bowel itself. Given the increasing frequency of women undergoing surgical management of pelvic organ prolapse which involves techniques using synthetic mesh, it is important to consent patients appropriately for such life-threatening risks and to focus on the development of surgical techniques and mesh materials to minimise such complications.