Amid described a "meshoma" that may develop in a patient in whom prosthetic mesh material has been used to close an abdominal wall hernia. This can cause significant pain for the patient and so it is important to recognize and correct the problem. The author is from the Lichtenstein Hernia Institute in Los Angeles.


Diagnostic features:

(1) history of abdominal wall hernia repair using prosthetic mesh

(2) bunching up of the prosthetic material into a mass ("meshoma")

(3) chronic pain, especially if nerves are entrapped in the mesh

(4) detectable on CT or MRI images (but it may be misinterpreted)


Risk factors for its development:

(1) not fixing the mesh

(2) insufficient fixation of the mesh

(3) insufficient dissection to make room for the mesh

The mesh becomes folded and wrinkled. With scarring, muscle contraction, and changing pressures the mesh can wad up into a mass.


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