Volume 10, Issue 1
Case Report / Published: July 2022
V. Sirakov, I. Ivanov, E. Eyupov, T. Trichkov, S. Murvakov, V. Ivanov, R. Kostadinov, V. Melnikov, V. Mihailov, N. Vladov
Clinic of Hepato-biliary and Pancreatic Surgery and Transplantology, Military Medical Academy, Sofia
Introduction: Postoperative ventral hernias are one of the most common complications of abdominal surgery. Synthetic meshes aim to reduce the complication rates and the incidence of recurrent hernias.
Case report: We present the case of a 42-year-old patient after emergency surgery for volvulus of the sygmoid colon and diverticulitis. Resection of the sygmoid colon with descenso-recto anastomosis and protective supraumbilical transversostomy was performed. 5 months following the surgery relaparotomy and restitution of the gastrointestinal tract was performed. During the surgery, massive adhesions and a significant postoperative ventral hernia were found. After adhesiolysis and anastomosis of the colon, a two-component mesh was sutured on the hernia defect. A month after the surgical intervention several fistulas were observed and the patient was febrile. Revision of the wound and excision of the fistulas was performed.
Conclusion: Entero-cutaneous fistulas are one of the most common and serious complications following surgery of the abdominal wall due to ventral hernia. Surgical treatment is the most important step and includes resection of the enteral segment involved in the fistula and correction of the metabolic abnormalities.
1. M. Mudge and L. E. Hughes, “Incisional hernia: a 10-year prospective study of incidence and attitudes,” British Journal of Surgery, vol. 72, no. 1, pp. 70–71, 1985.
2.Kanters AE, Krpata DM, Blatnik JA, Novitsky YM, Rosen MJ. Modified hernia grading scale to stratify surgical site occurrence after open ventral hernia repairs. J Am Coll Surg 2012;215:787-93.
3. Leber GE, Garb JL, Alexander AI, et al. Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 1998;133:378–382.
4. I. Yilmaz, D.O. Karakasё, I. Sucullu, Y. Ozdemir, and E. Yucel, “A rare cause of mechanical bowel obstruction: mesh migration,” Hernia, vol. 17, no. 2, pp. 267–269, 2013.
5. Seker D, Kulacoglu H. Long-term complications of mesh repairs for abdominal-wall hernias. J Long Term Eff Med Implants 2011;21:205–218.
6. Sanchez VM, Abi-Haidar YE, Itani KMF. Mesh infection in ventral incisional hernia repair: incidence, contributing factors, and treatment. Surg Infect (Larchmt) 2011;12:205-10
7. Montgomery A. The battle between biological and synthetic meshes in ventral hernia repair. Hernia 2013;17:3–11.
Postoperative ventral hernia, entero-cutaneous fistula
How to cite this article:
Sirakov V, Ivanov I, Eyupov E, Trichkov T, Murvakov S, Ivanov V, Kostadinov R, Melnikov V, Mihailov V, Vladov N. Enterocutaneous fistula in postoperative ventral hernia—a clinical case. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2022; 10(1):53-55
Dr. Vasil Sirakov
Clinic of Hepato-Pancreatic and Transplant Surgery
Military Medical Academy of Sofia
Address: 3, Sv. Georgi Sofiyski blvd, 1606, Sofia
E-mail: sirakov83 @ start.bg