Hernial mesh and adynamic ileus

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

The patient is post an infra-umbilical hernia repair. There is ongoing abdominal pain and distension.

Patient Data

Age: 45 years
Gender: Female
x-ray

The post-operative abdominal x-ray confirms distended small bowel loops with air-fluid levels, There is no free intraperitoneal air. There are central pelvic radio opaque, hernia wire mesh repair, non-absorbable, permanent surgical tacks.

Case Discussion

An example of small bowel ileus in a setting of a recent anterior abdominal wall hernia repair (infra-umbilical ), confirmed on a post-operative Gastrografin challenge (not uploaded).

There is a wire mesh repair with permanent, titanium, non-absorbable, surgical fixation tacks as demonstrated by the spiral spring-like metallic artifacts.

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