Diagnosis of mesh infection after abdominal wall hernia surgery - role of radionuclide methods

Hepatogastroenterology. 2011 Sep-Oct;58(110-111):1455-60. doi: 10.5754/hge11085. Epub 2011 Jul 15.

Abstract

Background/aims: The aim of this investigation was to evaluate the role of detection of late mesh infection following incisional hernia repair with radiolabeled antigranulocyte antibodies.

Methodology: Mesh infection diagnoses were set up with clinical examination and laboratory analysis and confirmed by ultrasonography (US), computerized tomography (CT), scintigraphy with 99mTc-antigranulocyte antibodies and microbiological examination.

Results: Of the 17 patients investigated, 6 had a late mesh infection, and 11 had both mesh infection and recurrent incisional hernia. Clear clinical signs of late mesh infection were present in 13 patients. Four remaining patients had non-specific discomfort and recurrent incisional hernia without clinical manifestation of mesh infection ('silent infection'). US was positive in 12/17 patients, CT in 13/17 patients, while scintigraphy with antigranulocyte antibodies in 17/17 patients. Therefore, sensitivity of US was 71%, of CT 76% and of scintigraphy 100%. In four patients late mesh infection was confirmed exclusively by 99mTc-antigranulocyte antibody scintigraphy, while US and CT did not indicate the infection.

Conclusions: According to the present results, scintigraphy with 99mTc antigranulocyte antibodies is a useful method for the detection of 'silent' abdominal wall infections after surgery, which is very important for prompt and appropriate therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived*
  • Female
  • Hernia, Abdominal / surgery*
  • Humans
  • Male
  • Middle Aged
  • Organotechnetium Compounds*
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Recurrence
  • Surgical Mesh*
  • Surgical Wound Infection / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Ultrasonography

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Organotechnetium Compounds
  • Radiopharmaceuticals