Jornal de Patologia Médica e Cirúrgica
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Chronic Abdominal Pain following the TAPP Hernioplasty, Caused by Appendix Attached to the Polypropylene Mesh

Rakic Mislav, Klicek Robert, Amic Fedor, Matej Andabak and Patrlj Leonardo

We report a case of 42 y old male patient with chronic pain in the lower right abdominal quadrant that appeared almost every time after or during exercise, for a last two years. The patient underwent transabdominal preperitoneal patch hernioplasty (TAPP), due to the right inguinal hernia two and a half years ago. There were no comorbidities or other previous operations in his medical records. Since the abdominal ultrasound (US) and magnetic resonant (MR) with laboratory methods did not show any special findings, the laparoscopy was performed and the appendix was found with apex attached to the polypropylene mesh, preperitoneal positioned at the place of the previous hernioplasty. The appendix was divided carefully and the laparoscopic appendectomy was performed. There were no complications during the operation or postoperative period. The pathohistological exam showed chronic inflammatory mononuclear infiltration at the sampled appendix. During the follow-up period of two years, the patient experienced no abdominal pain nor any other symptoms and/or complications. In the current literature, we did not find this kind of complication following the TAPP procedure. This case is a unique presentation of chronic abdominal pain following the TAPP procedure caused with the position of the attached appendix.