Retained abdominal textile surgical meshes: imagistic signs

Abstract

Introduction. Retained textile surgical meshes (TSM) which are left unintentionally in abdominal cavity are a problem despite precautions measures. Being qualified as major medical error, they are rarely reported. The natural evolution of condition is indistinct, whereas diagnosis and treatment are difficult and not standardized. Aim of the study. To determine typical imagistic signs of textile surgical meshes with other surgical and non-surgical pathologies. Materials and methods. During a 17 year period nineteen patients with retained TSM were admitted in two Departments of Surgery. Males – 6, females – 13, with median age 32.8 years. Time to readmission after first surgery ranged from 5 days to 15 years. Imaging studies included abdominal radiography, ultrasound scan, and computed tomography. Results. Transabdominal ultrasound had shown a well-defined mass with a strong posterior shadow. Computed tomography revealed a well-defined „spongiform” mass with gas bubbles inside. In one case the diagnosis was made by upper gastrointestinal endoscopy. Thirteen patients underwent repeated surgery with removing surgical meshes and drainage ofcontaminated intra-abdominal collection, one – partial gastrectomy for suspected tumor, and one – endoscopic removing of surgical mesh through stomach. Conclusions. Retained textile surgical mesh should be considered as a possible diagnosis in any postoperative patient, who presents with signs of peritoneal infection or with abdominal mass. Repeated surgery is usually required for removing surgical meshes from abdominal cavity.