Systemic allergic reaction and chronic inguinal neuralgia after implantation of a prosthesis in an inguinal hernioplasty

Introduction: The use of prosthesis in the repair of inguinal hernia has an underestimated morbidity. The aim of this study is to describe a case of prosthesis rejection due to metals allergy and intractable inguinal neuralgia. Method: We describe the case of a 42-year-old man who, after a hernioplasty with a polypropylene prosthesis, develops a disabling systemic disease and a chronic inguinal neuralgia that does not respond to medical treatment. Results: Extirpation of all implanted foreign material and triple neurectomy is performed anteriorly. At 6 months, there were no complications and the general symptomatology, inguinal neural pain disappeared and the analytical was normalized (IgE). Conclusions: 1. The operation of an inguinal hernia should be indicated by the surgeon after clinical exploration, never by a routine ultrasound. 2. Prostheses can cause allergic and systemic clinical reaction. 3. Possibly, many patients with small primary hernias could be treated with equal safety by anatomical techniques. 4. The creation of Abdominal Wall Units is necessary and should be considered as a requirement in accredited centers to train residents of general surgery.