title: Mesh expansion as the cause of bulging after abdominal wall hernia repair.
abstract: BACKGROUND
  Recurrence is the most important complication of abdominal wall reconstruction. It is possible the repair itself is intact, but bulging or expansion of mesh causes recurrent swelling's of the abdominal wall.
  
  
  METHODS
  In this report, we present bulging of a polyester mesh due to central pore expansion.
  
  
  CONCLUSIONS
  Repetitive stress and variations in intra-abdominal pressure can change tensile strength and stretches mesh materials.
  
  
  CONCLUSIONS
  A swelling after abdominal wall repair can be caused by bulging of the mesh. A progressive bulging might be the result of failure of the mesh implant due to elongation. Mesh characteristics should be considered when choosing a feasible and suitable mesh for abdominal wall reconstruction. Clinical distinction between recurrent hernia and mesh bulging is difficult but therapeutically irrelevant in symptomatic patients.
authors.affiliation: Department of Surgery, Erasmus University Medical Center Rotterdam, The Netherlands. Electronic address: e.deerenberg@erasmusmc.nl.
authors.forename: E B
authors.initials: EB
authors.lastname: Deerenberg
authors.affiliation: Department of Surgery, Erasmus University Medical Center Rotterdam, The Netherlands. Electronic address: j.verhelst@erasmusmc.nl.
authors.forename: J
authors.initials: J
authors.lastname: Verhelst
authors.affiliation: Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, The Netherlands. Electronic address: s.e.r.hovius@erasmusmc.nl.
authors.forename: S E R
authors.initials: SER
authors.lastname: Hovius
authors.affiliation: Department of Surgery, Erasmus University Medical Center Rotterdam, The Netherlands. Electronic address: j.lange@erasmusmc.nl.
authors.forename: J F
authors.initials: JF
authors.lastname: Lange
keywords: Abdominal wall reconstruction; Bulging; Case report; Mesh; Recurrence