Colocutaneous fistula due to polypropylene mesh.

Fistulae due to polypropylene mesh are known to occur if the prosthetic mesh is placed close to a hollow viscus. Some cases of enterocutaneous fistula have been reported but there are few cases of fistula affecting the large bowel. It is important to recognize these cases because they are severe complications of the prosthesis and difficult to manage. We present a case of colocutaneous fistula caused by fragmentation of polypropylene mesh and erosion into the sigmoid colon after recurrent incisional hernia repair.

Postoperative textilomas: review of 14 cases.

BACKGROUND: Textile materials of surgical origin are found in the abdominal cavity in between 1/1300 and 1/1500 laparotomies, in spite of preventive measures. It is very difficult to ascertain the exact incidence due to the lack of descriptions in the literature. METHODS: Fourteen cases of postoperative foreign bodies or textilomas are reported. The cases were collected from two hospital centers between 1985 and 1997. RESULTS: There were 12 intra-abdominal cases, 1 thoracic and 1 paravertebral. In 8 (57.1%) diagnosis was made preoperatively by radiological techniques. The mortality rate was 14.2% with 2 deaths due to multiorganic failure in one case and sepsis in the other. Both patients were over 70, with malignant pathology. The morbidity rate was 21.4%, wall abscesses which evolved favorably being the most frequent cause of complications. CONCLUSIONS: Prevention of this complication is the best treatment. It is advisable to use textile material with radiopaque contrast, to count the pieces of material to be used and perform an X-ray before the laparotomy is closed specially in emergency (bleeding and trauma patients) because in these complex cases the possibility of material being left behind is more advisable.