Mimicker: Inguinal Mesh Plug
Depending on the inguinal hernia repair method chosen, a mesh plug can be used for reinforcement. One such method uses a polypropylene (Prolene) plug
- The post-operative appearance of an inguinal mesh plug can masquerade as an inguinal mass or lymphadenopathy
- On CT, mesh plugs can have a slightly nodular or smooth outline. The density is similar to sightly lower than muscle. Mesh plugs have also been reported as a ring-like density with central fat attenuation, potentially mimicking epiploic appendicitis if on the left
- On MRI, mesh plugs are typically T1 hypointense and demonstrate variable T2 weighted signal
- Due to a granulomatous reaction, mesh plugs can be FDG avid
Helpful hints in preventing misdiagnosis
- Mutliplanar reformations can be useful in demonstrating the conical morphology of the mesh plug, although they can appear ovoid
- Postsurgical changes including skin thickening and suceptabliity artifact can also be helpful imaging features
|Left inguinal mesh plug with a lobular contour
|Left inguinal mesh plug. Note conical morphology on this coronal MPR.
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