Multidetector CT of expected findings and early postoperative complications after current techniques for ventral hernia repair

UNLABELLED Current techniques for ventral hernia repair (VHR) rely on prosthetic mesh implantation and are increasingly performed laparoscopically. Potentially serious iatrogenic complications may occur following VHR, though these are rare compared to the vast number of procedures performed each year. This paper provides an overview of contemporary open and laparoscopic surgical techniques and biomaterials, then reviews and illustrates the expected postoperative imaging appearances, and common and unusual early complications after VHR. Emphasis is placed on multidetector computed tomography (CT), which comprehensively visualizes the operated anterior abdominal wall and deeper intra-abdominal structures. CT consistently allows diagnosis of postoperative seromas, abdominal wall abscesses and fistulas, haemorrhages with or without active bleeding, bowel obstruction, peritonitis and recurrent hernias, and thus providing a reliable basis for an appropriate choice between conservative, interventional, or surgical treatment. Familiarity with early post-surgical CT is warranted to avoid misinterpretation of the expected imaging appearance and correctly elucidate postoperative complications after VHR. TEACHING POINTS • Open and laparoscopic repair of ventral hernias rely on prosthetic mesh implantation. • Potentially serious iatrogenic complications occasionally occur after ventral hernioplasty. • Multidetector CT consistently evaluates the operated abdominal wall and deeper structures. • Familiarity with the expected early postoperative imaging appearance is required. • Complications include seroma, infections, haemorrhage, bowel obstruction, peritonitis, and recurrence.