The SAGES Manual of Groin Pain by Brian P. Jacob David C. Chen Bruce Ramshaw & Shirin Towfigh

Author:Brian P. Jacob, David C. Chen, Bruce Ramshaw & Shirin Towfigh
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Mesh Complications

Mesh complications often present with subtle imaging findings, and may require knowledge of the operative technique utilized to diagnose definitively. US does not reliably identify the mesh, especially if it is folded, balled up, or otherwise complicated (Fig. 19.3). As such, US is not recommended as a first-line imaging modality to evaluate the postoperative groin after mesh implantation when the integrity of the mesh itself is in question. Due to the combination of low material density and minimal profile, normal mesh material is often indistinguishable from surrounding tissue on CT [2], requiring the radiologist to discern a postoperative state from the presence and location of the patient’s surgical scars (Fig. 19.4). Even in states of chronic inflammation (e.g., mesh reaction), it may be impossible to specifically identify pathology on the basis of CT alone. On MR, flat mesh materials appear as dark linear bands on T1 sequences, slightly thicker than normal fascial planes, but may be more difficult to identify among their surrounding tissues on fluid-sensitive sequences (Fig. 19.5).

Fig. 19.3.The flat mesh (white arrows) shown on this Doppler US is hardly conspicuous, and would be even less so if not for the small fluid collection (curved white arrow) overlying it.

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