Enterocutaneous fistula in postoperative ventral hernia - clinical case

Abstract

Introduction: Postoperative ventral hernias are one of the most common complications of abdominal surgery. Synthetic meshes aim to reduce the complication rates and the incidence of reccurent hernias. Case report: We present the case of a 42-year-old patient after emergency surgery for volvulus of the sygmoid colon and diverticulitis. Resection of the sygmoid colon with descenso-recto anastomosisand protective supraumbilical transversostomy was performed. 5 months following the surgery relaparotomy and restitution of the gastrointestinal tract was performed. During the surgery, massive adhesions and a significant postoperative ventral hernia were found. After adhesiolysis and anastomosis of the colon, a two-component mesh was sutured on the hernia defect. A month after the surgical intervention several fistulas were observed and the patient was febrile. Revision of the wound and excision of the fistulas was performed. Conclusion: Entero-cutaneous fistulas are on of the most common and serious complications following surgery of the abdominal wall due to ventral hernia. Surgical treatment is the most important step and includes resection of the enteral segment involved in the fistula and correction of the metabolic abnormalities.