Enterocutaneous fistula 14 years after prosthetic mesh repair of a ventral incisional hernia: A life-long risk?

The patient was an 82-year-old woman with Munchausen syndrome who had undergone multiple abdominal operations, including appendectomy, cholecystectomy, hysterectomy, bilateral salpingo-oophorectomy, splenectomy, adhesiolysis, and right hemicolectomy. She also had undergone three operations to repair a recurrent ventral incisional hernia. The last repair, in which Marlex mesh was used, had been performed 14 years before. In that procedure a subfascial technique was used, with the mesh being secured to the edges of the fascial defect.