# An Unusual Case of Ileitis and Partial Small Bowel Obstruction Secondary to Mesh Erosion After Totally Extraperitoneal Inguinal Hernia Repair

## TL;DR

A young man's abdominal pain was initially thought to be Crohn's disease, but it was later found to be caused by mesh erosion from a previous hernia repair.

## Contribution

Highlights mesh erosion as a rare but important differential diagnosis for ileitis in young adults post-TEP hernia repair.

## Key findings

- Mesh erosion after TEP hernia repair can mimic ileocolic Crohn's disease in young adults.
- Persistent symptoms and negative initial tests necessitate broader differential diagnosis and subspecialty involvement.
- Bowel resection resolved the issue, with full recovery observed at 6 weeks.

## Abstract

The objectives were to highlight that: (1) mesh erosion related partial small bowel obstruction after laparoscopic totally extraperitoneal (TEP) inguinal hernia repair (IHR) as an uncommon complication can clinically and radiologically mimic ileocolic Crohn's disease in young adults; and (2) implore clinicians to consider a broad set of differential diagnosis and prompt involvement of other subspecialties, especially if preliminary investigations and treatment yield minimal results. The authors report a 34-year-old male who presented with computed tomography (CT) findings of ileitis, which was initially investigated for Crohns' disease. Due to persisting abdominal pain and negative initial investigations, he underwent a laparotomy demonstrating secondary mesh migration with erosion into distal ileum requiring bowel resection, 2.5 years after an uneventful laparoscopic right TEP IHR. The patient made an uneventful postoperative recovery and at 6 weeks follow-up, he had resolution of abdominal pains, and normal bowel function.