Inguinal hernia repair plug refers to a nonabsorbable material such as a polypropylene inserted intraoperatively into an inguinal hernial defect.
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Pathology
Usually located anterior to the iliac vessels at the level of the inguinal canal. Size varies with mean long axis diameter 2.6 cm. Unilateral or bilateral. May be single or multiple at one side. Prolene plug is of soft-tissue density and may be misdiagnosed as lymphadenopathy.
Complications
- recurrence of inguinal hernia
- infection
- migration of the plug to the inguinal canal
- testicular atrophy
Radiographic features
CT
Nodular lesion similar to or lower in density than the adjacent muscle. A small amount of surrounding or internal fat is characteristic. Internal air may be seen within the postoperative period or due to local inflammation/ infection.
Ultrasound
Unilateral or bilateral hyperechoic focal masses with posterior shadowing. Smooth or slightly nodular in outline.
PET
No significant 18F-FDG uptake to increased FDG uptake.
MRI
- T1: low signal
- T2: low to intermediate or slightly high signal on T2-weighted images relative to the adjacent musculature
The periphery or majority of the Prolene plug may enhance.