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Case Reports in Emergency Medicine
Volume 2014 (2014), Article ID 848030, 3 pages
http://dx.doi.org/10.1155/2014/848030
Case Report

Emergency Open Incarcerated Hernia Repair with a Biological Mesh in a Patient with Colorectal Liver Metastasis Receiving Chemotherapy and Bevacizumab Uncomplicated Wound Healing

1Department of Surgery, The London Clinic, 20 Devonshire Pl, London W1G 6BW, UK
2Upper GI/HPB Unit, Department of Academic Surgery, Royal Marsden Hospital, Fulham Roadd, London SW3 6JJ, UK
3Division of Transplantation, Department of Surgery, Hippokration General Hospital, Aristotle University of Thessaloniki, 49 Kostantinoupoleos Street, 54642 Thessaloniki, Greece

Received 13 October 2014; Accepted 4 December 2014; Published 21 December 2014

Academic Editor: Vasileios Papadopoulos

Copyright © 2014 Alexandros Giakoustidis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF), often used in combinational chemotherapy regimens for the treatment of patients with colorectal liver metastases. However adverse events have been attributed to the use of bevacizumab including gastrointestinal perforations, thrombotic events, hypertension, bleeding, and wound healing complications. 53-year-old male, with a history of colorectal cancer with liver metastasis, receiving a combination of cytotoxic chemotherapy (FOLFIRI, irinotecan with fluorouracil and folinic acid) with bevacizumab presented as an emergency with an incarcerated incisional hernia. The last administration of chemotherapy and bevacizumab had taken place 2 weeks prior to this presentation. As the risk of strangulation of the bowel was increased, a decision was made to take the patient to theatre, although the hazard with respect to wound healing, haemorrhage, and infection risk was high due to the recent administration of chemotherapy with bevacizumab. The patient underwent an open repair of the incarcerated recurrent incisional hernia with placement of a biological mesh, and the postoperative recovery was uncomplicated with no wound healing or bleeding problems.