An area of thinned and weak abdominal wall through which intestines can protrude is called an abdominal hernia. The Merck Manual states a hernia can be present at birth or acquired, usually after an abdominal operation. An abdominal hernia usually is asymptomatic. Because hernias can become strangulated, a condition in which the blood supply to the hernia and intestines is interrupted leading to gangrene, surgical repair is usually recommended. Augirre and colleagues reported in a November 2005 article published in "Radiographics," that more than one million hernia repairs are done a year. Mesh, a porous-type material that helps support the weakened abdominal wall, is used in most abdominal wall repairs. Although the use of mesh has substantially decreased the complication rate, complications can occur in up to 50 percent of cases.
Hernia Recurrence
According to PubMed.gov, hernias recur after surgical repair of a hernia with mesh in less than 10 percent of cases. Recurrence usually occurs two to three years after surgery. Risk factors for recurrence include obesity, diabetes and hernia repairs done under emergent conditions such as for strangulation. Surgical intervention to re-do the hernia repair is the only definitive treatment for this complication.
Fluid Collection
The "Radiographics" article reported that fluid collection, sometimes called a seroma, is the most common immediate postoperative complication seen after hernia repair with mesh, occurring in up to 17 percent of cases. Usually a seroma will resolve on its own; if it persists beyond 6 weeks postoperatively, aspiration of the seroma or surgical drainage is required.
Infection
Infection is the most serious complication of mesh hernia repairs, reports PubMed.gov, occurring in up to 5 percent of patients. Fluid collections can become infected as well as the mesh material itself. During repair of the hernia, occasionally the intestines can be nicked, releasing intestinal contents into the abdominal cavity, which can result in peritonitis, sepsis and death. Risks for infectious complications from a hernia repair with mesh include female gender and a hernia repair done for a strangulated hernia. Initial treatment is with intravenous antibiotics. Often drainage of the infection is required with removal of the mesh material required in some cases. Infection is a major risk factor for hernia recurrence.
References
- The Merck Manuals Online Medical Library: Hernias of the Abdominal Wall
- "Radiographics": Abdominal Wall Hernias: Imaging Features, Complications and Diagnostic Pitfalls at Multi-Detector Row CT. D. Augirre et. al.; November 2005
- PubMed.gov: Perioperative Outcomes And Complications Of Laparoscopic Repair
