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• W2978084723 abstract "Patients with medically refractory gastroesophageal reflux disease often require surgical intervention in the form of a fundoplication with or without a hiatal hernia repair. Complications of this surgery include visceral herniation and hernia recurrence. The use of synthetic mesh during hiatal hernia repair limits hernia recurrence but there are some reports of mesh erosion into thoracic or abdominal organs after such surgery. Removal of eroding mesh can be a major operation potentially requiring gastrectomy or esophagogastrectomy. We present a rare case of an endoscopic diagnosis and successful removal of a chronically perforating gastric mesh in a patient with a history of a Nissen fundoplication and hiatal hernia repair. A 54-year-old woman with medically refractory acid reflux underwent an uneventful laparoscopic Nissen fundoplication for a hiatal hernia using synthetic mesh. About a year after, she was seen for progressively worsening dysphagia to solids and liquids. A barium esophagram showed no evidence of reoccurrence of hiatal hernia, esophageal stenosis or dysmotility. Esophageal manometry was also unremarkable. At subsequent follow up, she had lost an additional 15 pounds due to her symptoms. An EGD was performed showing a 6 cm long mesh eroding into the gastric fundus pushing against the cardia. The wrap itself appeared intact and was easily traversed. Using a combination of endoscopic tools including cold snare and rat-tooth forceps, the mesh and associated pledgets were removed in their entirety. The examined granulation site in the fundus did not reveal any evidence of obvious perforation. A post procedure upper GI series also did not reveal any contrast extravasation. At follow up, the patient reported marked improvement in her dysphagia symptoms.Figure 1Figure 2We present an incredibly rare case of synthetic mesh eroding into the gastric fundus presenting clinically as worsening dysphagia. Foreign body erosion into the stomach has been reported as a complication after bariatric surgery but to our knowledge is exceedingly rare after hiatal hernia repair. Moreover, successful endoscopic removal of the mesh saved this patient from a potentially arduous and complicated surgery." @default.
• W2978084723 created "2019-10-10" @default.
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• W2978084723 date "2016-10-01" @default.
• W2978084723 modified "2023-09-27" @default.
• W2978084723 title "A Chronically Perforating Foreign Body Causing Dysphagia: What a Mesh!" @default.
• W2978084723 doi "https://doi.org/10.14309/00000434-201610001-01544" @default.
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