# Obscure Small Bowel Bleeding Related to a Ventral Hernioplasty Mesh Perforation Visualized With Video Capsule Endoscopy

## TL;DR

A 76-year-old woman with a history of hernioplasty experienced small bowel bleeding due to mesh erosion, diagnosed using video capsule endoscopy.

## Contribution

Highlights the rare but important cause of obscure GI bleeding related to mesh hernioplasty and the utility of video capsule endoscopy in diagnosis.

## Key findings

- Mesh erosion into the small bowel caused transfusion-dependent GI bleeding.
- Video capsule endoscopy identified the source of bleeding after prior endoscopies failed.
- Early differential diagnosis is crucial for patients with obscure GI bleeding and a history of hernioplasty.

## Abstract

We report a case of a 76-year-old female presenting with intermittent obscure gastrointestinal (GI) bleeding originating from the small intestine secondary to a delayed complication related to mesh hernioplasty. The mesh was eroding into the small bowel causing intermittent transfusion-dependent GI bleeding. Multiple upper and lower endoscopic investigations were sought over the last two years, but they were noncontributory. Finally, video capsule endoscopy (VCE) revealed mesh invasion into the small bowel wall associated with bleeding. This case emphasizes the significance of an early sufficient differential diagnosis in patients with obscure GI bleeding. Meanwhile, being cognizant of rare causes of GI bleeding in patients who have had hernioplasty is very important.