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Mesh Plug Appearing As Cecal Mass On Colonoscopy
Stacie E Perlman, Steven Yood, Stephen Stein, Phillip Jaffe, Jamie Rand
Hospital of Saint Raphael, New Haven, CT
Objective: Development of a minimally invasive approach to the diagnosis of a submucosal cecal mass
Design: Case series
Setting: Community teaching hospital
Patients: 2 patients presenting for evaluation of colonoscopically identified submucosal masses with previous history of right inguinal hernia repair with mesh plug
Interventions: One patient underwent laparoscopy with intraoperative colonoscopy to confirm the nature of the colonoscopically located lesion and that manipulation of the mesh was associated with lesion movement seem on colonoscopy. The second patient underwent laparoscopy and mini-laparotomy for cecal palpation to rule out concurrent lesions.
Main Outcome Measures: This is a report of two clinical cases, demonstrating an important inclusion in the differential diagnosis of submucosal cecal masses. Outcome measures were not included in this article.
Results: Both patient were able to secure a diagnosis while avoiding the risks associated with partial colectomy.
Conclusions: A minimally invasive approach, utilizing laparoscopy and intraoperative endoscopy provides the ultimate diagnostic capability and can prevent unnecessary laparotomy. Though migrating mesh is a rare cause of an observed lesion on colonoscopy, it does occur and must be a part of the differential diagnosis for a smooth-walled submucosal colonic lesion.
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