A 49-year-old man presented to the emergency department with a six-week history of fevers, weight loss and feeling unwell with anorexia. He had a history of a laparoscopic transabdominal pre-peritoneal left inguinal hernia repair seven weeks prior. An abdominal computer tomography scan showed a collection surrounding the mesh. Initial management involved oral antibiotics and ultrasound-guided drainage. Unfortunately, his symptoms and the collection persisted, and he required surgical intervention. After laparoscopy confirmed the containment of the infection to the pre-peritoneal space, the collection was approached via a moderate skin incision above the inguinal canal. This approach allowed for drainage of the collection, removal of the mesh and a thorough washout and drain placement without disturbing future hernia repair options nor exposing the intra-abdominal compartment to infection. The patient recovered well and was discharged five days after the operation. He did require another brief period of intravenous antibiotics before being discharged once more.
Key words: mesh infection, TAPP hernia repair, general surgery
|