title: Complete transmural gastric migration of PTFE mesh after surgery for a recurrent hiatal hernia.
abstract: Complications directly associated with the use of prosthetic materials in large hiatal hernia repair are rarely cited events in the literature. We herein report a case of a 47 year-old woman who came to our attention for a subacute onset of severe dysphagia and weight loss. She previously underwent laparotomic Nissen fundoplication with PTFE dual-mesh cruroplasty for a large recurrent hiatal hernia. With the clinical suspicious of "Tight Nissen", an endoscopy was performed and revealed a circular stenosis in the lower esophagus, a rotation of the stomach and, surprisingly, the presence of PTFE mesh free-moving in the gastric lumen With the use of rattooth forceps, the foreign body was removed and, after few days, the patient underwent a surgical debridement of hiatal scar tissue and a gastropexy procedure. In conclusion, dysphagia may manifest during the early postoperative period after mesh repair antireflux surgery, but such dysphagia usually resolves; if it doesn't or if it worsens, mesh migration must be excluded.
authors.affiliation: Department of Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy. vporziella@rm.unicatt.it
authors.forename: V
authors.initials: V
authors.lastname: Porziella
authors.forename: A
authors.initials: A
authors.lastname: Cesario
authors.forename: F
authors.initials: F
authors.lastname: Lococo
authors.forename: S
authors.initials: S
authors.lastname: Margaritora
authors.forename: G
authors.initials: G
authors.lastname: Leuzzi
authors.forename: M
authors.initials: M
authors.lastname: Marchese
authors.forename: L
authors.initials: L
authors.lastname: Petruzziello
authors.forename: G
authors.initials: G
authors.lastname: Costamagna
authors.forename: P
authors.initials: P
authors.lastname: Granone
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D018662:Fundoplication / Q000009:adverse effects; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D011138:Polytetrafluoroethylene; D012008:Recurrence; D013270:Stomach; D013526:Surgical Mesh / Q000009:adverse effects*
chemical_list: D011138:Polytetrafluoroethylene