Colonic Penetration after Kugel Patch Inguinal Hernia Repair

Takeshi Shioya, Satoshi Nomura, Yoshimasa Watanabe, Kotaro Nanbu, Suehumi Aosasa⁴⁾, Taro Yamada, Tetsuo Shibuya, Kunio Yanagimoto¹⁾, Akira Tokunaga²⁾ and Takashi Tajiri³⁾

Department of Surgery and Department of Pathology¹⁾, Saitama Citizen Medical Center
Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital²⁾
Surgery for Organ Function and Biological Regulation, Nippon Medical School Graduate School of Medicine³⁾
Department of Surgery, Social Insurance General Omiya Hospital⁴⁾

A 69-year-old man was seen for a lower right abdominal tumor 2 years after right inguinal hernia repair with a Kugel patch. He was operated right inguinal hernia and appendectomy in childhood. Computed tomography (CT) and barium enema examination found to have an abscess formation due to right side colonic diverticulitis. Operative findings showed the cecum strongly adhering to the abdominal wall, with the patch adhering to and penetrating the cecum and forming part of the tumor. The patch was removed and the ileocecum resected. Actinomyces infection was recognized pathologically in the abscess. Despite paralytic ileus and postoperative surgical site infection, the man recovered with conservative treatment. This is, to our knowledge, the first report to demonstrate that colonic penetration after Kugel patch inguinal hernia repair.

Key words
Kugel patch, migration, colon diverticulitis

Reprint requests
Takeshi Shioya Department of Surgery, Saitama Citizen Medical Center
299-1 Shimane, Nishi-ku, Saitama, 331-0054 JAPAN

Accepted
May 27, 2009

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