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  • Generalised peritonitis from strangulated small bowel obstruction secondary to mesh erosion: a rare long-term complication of laparoscopic mesh sacrohysteropexy

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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Generalised peritonitis from strangulated small bowel obstruction secondary to mesh erosion: a rare long-term complication of laparoscopic mesh sacrohysteropexy
  1. Constantinos Simillis1,2,
  2. Olivia James1,
  3. Kiranpreet Gill1 and
  4. Yimeng Zhang1
  1. 1 Department of Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  2. 2 Department of Surgery and Cancer, Imperial College London, London, UK
  1. Correspondence to Mr Constantinos Simillis, csimillis{at}gmail.com

Abstract

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.

  • obstetrics and gynaecology
  • gastrointestinal surgery
  • small intestine

https://doi.org/10.1136/bcr-2018-226309

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    Footnotes

    • Contributors All four authors cared for study patient and had a substantial contribution to preparation of the manuscript. CS: conception and design, supervision throughout, discussed case report with patient and family, acquisition of data, interpretation of data, drafting the article and revising it critically for important intellectual content, created revised versions based on reviewer comments, final approval of the version published, agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved. OJ: discussed case report with patient and family and gained consent from patient, acquisition of data, interpretation of data, drafting the article and revising it critically for important intellectual content, created revised versions based on reviewer comments, final approval of the version published. YZ: acquisition of data, interpretation of data, obtained and edited figures used, drafting the article and revising it critically for important intellectual content, final approval of the version published. KG: acquisition of data, interpretation of data, drafting the article and revising it critically for important intellectual content, final approval of the version published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.