Enterocutaneous fistula as a postoperative complication of laparoscopic inguinal hernia repair

Trocar injuries to the small bowel during laparoscopic hernia repair are a rare complication, the most common complications being postoperative neural gias, scrotal swelling, scrotal ecchymosis, and hematoma. A 15-year-old boy was admitted 5 days status-post transabdominal laparoscopic inguinal herni a repair of a symptomatic right pantaloon hernia, with signs and symptoms o f a retrocecal abscess. Despite laparotic intervention and appendectomy, th e next 2 years passed with almost daily, purulent, right lower quadrant wou nd drainage, in an otherwise asymptomatic patient. Superficial wound explor ation and sinogram in 1996 revealed a sinus tract in direct communication w ith the small bowel. Elective laparotomy in December 1997 involved a succes sful resection of a 2.5-cm fistula with involved mesh, and the communicatin g small bowel through a midline incision, followed by a primary closure of the small-bowel opening. The patient has recovered without complications.