Can abdominal mesh be visible on an abdominal ultrasound (US)?

Visibility of Abdominal Mesh on Ultrasound

Yes, abdominal mesh can be visualized on abdominal ultrasound, appearing as an echogenic structure with mild acoustic shadowing that may have either a wavy or straight linear appearance depending on the time elapsed since surgery and fixation method. 1

Ultrasound Characteristics of Abdominal Mesh

• Mesh typically appears as an echogenic (bright) structure on ultrasound with mild acoustic shadowing behind it 1, 2
• The appearance changes over time after implantation:
  • In non-fixed mesh: Initially wavy (day 1-1 month), then becomes straight linear (3-12 months) 1
  • In fixed mesh: Initially straight linear, then becomes wavy after 3 months 1
• Polypropylene mesh (commonly used) is particularly visible on ultrasound imaging 3

Factors Affecting Mesh Visualization

• Mesh material composition affects echogenicity (polypropylene meshes are well-visualized) 2
• Time since implantation influences appearance due to tissue integration and healing 1
• Location of mesh placement affects visualization accessibility 4
• Patient body habitus may limit ultrasound penetration in some cases 5

Technical Considerations for Optimal Visualization

• High-frequency transducers (7.5-15 MHz) provide better resolution for superficial mesh 2
• Multiple scanning planes (transverse and longitudinal) should be used to fully evaluate the mesh 4
• Gentle compression during scanning can help differentiate mesh from surrounding tissues 2
• Dynamic assessment during Valsalva maneuver may help identify mesh-related complications 2

Limitations of Ultrasound for Mesh Evaluation

• Deep mesh placement may be difficult to visualize due to ultrasound depth limitations 5
• Bowel gas and obesity can limit ultrasound penetration and image quality 4, 5
• Mesh in the thoracic region cannot be adequately evaluated by abdominal ultrasound due to anatomical constraints including lung tissue and bony structures 5
• In 1-2% of cases, even abdominal structures cannot be adequately evaluated by ultrasound due to body habitus or excessive bowel gas 5

Common Mesh Complications Detectable by Ultrasound

• Mesh folding or contraction (appearing as wavy or bunched configuration) 3
• Seroma formation (appearing as anechoic or hypoechoic fluid collection) 2
• Hematoma (appearing as complex fluid collection) 2
• Mesh migration or displacement 2
• Recurrent hernia at mesh margins 1, 2

Ultrasound provides a radiation-free, cost-effective method for evaluating abdominal mesh and its potential complications, though CT or MRI may be required for more complex cases or when ultrasound findings are equivocal.