scholarly journals Ruptured adult umbilical hernia caused by intractable ascites associated with liver cirrhosis

2012 ◽  
Vol 73 (4) ◽  
pp. 1017-1020 ◽  
Author(s):  
Toru KUBO ◽  
Yasushi OKUSA
Keyword(s):  
Liver Cirrhosis ◽  
Umbilical Hernia ◽  
Intractable Ascites

scholarly journals A227 UMBILICAL HERNIA INCARCERATION IN LIVER CIRRHOSIS: A RARE COMPLICATION OF PARACENTESIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 263-265
Author(s):  
A LAGROTTERIA ◽  
A Aruljothy ◽  
K Tsoi
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Large Volume ◽  
Umbilical Hernia ◽  
Rare Complication ◽  
Abdominal Wall Hernia ◽  
Refractory Ascites ◽  
Large Volume Paracentesis

Abstract Background Patients with decompensated liver cirrhosis with ascites frequently have umbilical hernias with a prevalence of 20% and are managed with large volume paracentesis (LVP). Common complications of LVP include hemorrhage, infection, and bowel perforation that occur infrequently with a frequency of less than 1%. However, incarceration of umbilical hernias has been reported as a rare complication of LVP and is speculated to be from ascitic fluid decompression that reduces the umbilical hernia ring diameter resulting in entrapment of the hernia sac. It is unclear whether the quantity or the fluid removal rate increases the herniation risk. Based on case series, this rare complication occurs within 48 hours of the LVP and requires emergent surgical repair and involves a high risk of morbidity and mortality due to potential infection, bleeding, and poor wound healing. Aims We describe a case report of an incarcerated umbilical hernia following a bedside large-volume paracentesis. Methods Case report Results A 59-year-old Caucasian male presented to the emergency department with a 24-hour history of acute abdominal pain following his outpatient LVP. His medical history included Child-Pugh class C alcoholic liver cirrhosis with refractory ascites managed with biweekly outpatient LVP and a reducible umbilical hernia. He reported the onset of his abdominal pain 2-hours after his LVP with an inability to reduce his umbilical hernia. Seven liters of clear, straw-coloured asitic fluid was drained. Laboratory values at presentation revealed a hemoglobin of 139 g/L, leukocyte count of 4.9 x109 /L, platelet count of 110 xo 109 /L, and a lactate of 2.7 mmol/L His physical exam demonstrated an irreducible 4 cm umbilical hernia and bulging flanks with a positive fluid wave test. Abdominal computed tomography showed a small bowel obstruction due to herniation of a proximal ileal loop into the anterior abdominal wall hernia, with afferent loop dilation measuring up to 3.4 cm. He was evaluated by the General Surgery consultation service and underwent an emergent laparoscopic hernia repair. There was 5 cm of small bowel noted to be ecchymotic but viable, with no devitalized tissue. He tolerated the surgical intervention with no post-operative complications and was discharged home. Conclusions Ultrasound-guided bedside paracentesis is a common procedure used in the management of refractory ascites and abdominal wall hernia incarceration should be recognized as a potential rare complication. To prevent hernia incarceration, patients with liver cirrhosis should be examined closely for hernias and an attempt should be made for external reduction prior to LVP. A high index of suspicion for this potential life-threatening condition should be had in patients who present with symptoms of bowel obstruction following a LVP. Funding Agencies None

scholarly journals Outcome of sublay mesh repair in non-complicated umbilical hernia with liver cirrhosis and ascites

2014 ◽  
Vol 12 (2) ◽  
pp. 181-185 ◽  
Author(s):  
Ahmed Mohamed Abdelaziz Hassan ◽  
Asaad Fayrouz Salama ◽  
Hussam Hamdy ◽  
Magdy Mohamed Elsebae ◽  
Ayman Mohamed Abdelaziz ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Mesh Repair ◽  
Umbilical Hernia ◽  
Sublay Mesh

scholarly journals The influence of a peritoneovenous shunt for cirrhotic and malignant intractable ascites on renal function

2018 ◽  
Vol 7 (3) ◽  
pp. 205846011876420 ◽  
Author(s):  
Takafumi Segawa ◽  
Kenichi Kato ◽  
Kazuya Kawashima ◽  
Tomohiro Suzuki ◽  
Shigeru Ehara
Keyword(s):  
Renal Function ◽  
Liver Cirrhosis ◽  
Renal Dysfunction ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Intractable Ascites ◽  
Peritoneovenous Shunt ◽  
Catheter Obstruction ◽  
Peritoneovenous Shunts ◽  
The Relationship

Background Peritoneovenous shunts (PVS) are widely used for palliation of intractable ascites caused by peritoneal carcinomatosis (PC) or liver cirrhosis (LC). Some patients who need PVS have renal dysfunction. However, renal dysfunction is considered a relative contraindication. Therefore, it is important to assess renal function before PVS placement. Purpose To evaluate the relationship between PVS and renal function. Material and Methods Between October 2007 and July 2015, 60 patients (PC = 47; LC = 10; others = 3) underwent PVS placement for intractable ascites. Changes in estimated glomerular filtration rate (eGFR) and other adverse events (AEs) were retrospectively analyzed. Results Changes in eGFR before, one day after, and one week after PVS placement could be evaluated in 46 patients. The median eGFR before, one day after, and one week after was 56.5, 59.1, and 64.7 mL/min/1.73 m2, respectively ( P < 0.05). These values were 61.6, 72, and 67.1 mL/min/1.73 m2, respectively, in PC patients (n = 34; P < 0.05) and 28.5, 27, and 37.2 mL/min/1.73 m2, respectively, in LC patients (n = 10; P < 0.05). In 17 patients with moderate to severe renal dysfunction (eGFR < 45), these values were 23.4, 23.7, and 30.5 mL/min/1.73 m2, respectively. The most frequent AE was PVS catheter obstruction, which occurred in 12 patients (20.7%). Clinical disseminated intravascular coagulation occurred in six patients (10.3%) and caused death in three patients (5.2%). Conclusion PVS placement for intractable ascites is associated with various AEs. However, PVS appeared to promote renal function, especially in patients with renal impairment.

scholarly journals Four Cases of Peritoneo-Venous (Denver) Shunt System for Intractable Ascites Induced by Severe Liver Cirrhosis under General Anesthesia

2010 ◽  
Vol 30 (4) ◽  
pp. 629-633
Author(s):  
Arisa HOTTA ◽  
Yohei FUJIMOTO ◽  
Naoto HORI ◽  
Kumiko HIRAKAWA ◽  
Noriko YOSHIKAWA ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
General Anesthesia ◽  
Severe Liver ◽  
Shunt System ◽  
Intractable Ascites ◽  
Denver Shunt

scholarly journals Treatment of Intractable Ascites by Reinjection of Autogenous Ascites and Concentrated Ascites in Patients of Liver Cirrhosis

Kanzo ◽  
1974 ◽  
Vol 15 (2) ◽  
pp. 83-93
Author(s):  
Wataru OHTA ◽  
Masahiro NAKAGAWA ◽  
Takeshi OKADA ◽  
Minoru UKIDA ◽  
Yoshihiro SHIMADA
Keyword(s):  
Liver Cirrhosis ◽  
Intractable Ascites

scholarly journals Conservative treatment versus elective repair of umbilical hernia in patients with liver cirrhosis and ascites: results of a randomized controlled trial (CRUCIAL trial)

2020 ◽  
Author(s):  
B. de Goede ◽  
M. M. J. van Rooijen ◽  
B. J. H. van Kempen ◽  
W. G. Polak ◽  
R. A. de Man ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Liver Cirrhosis ◽  
Conservative Treatment ◽  
Umbilical Hernia ◽  
Controlled Trial ◽  
Number Of Patients ◽  
Umbilical Hernia Repair ◽  
Elective Repair

Abstract Purpose To establish optimal management of patients with an umbilical hernia complicated by liver cirrhosis and ascites. Methods Patients with an umbilical hernia and liver cirrhosis and ascites were randomly assigned to receive either elective repair or conservative treatment. The primary endpoint was overall morbidity related to the umbilical hernia or its treatment after 24 months of follow-up. Secondary endpoints included the severity of these hernia-related complications, quality of life, and cumulative hernia recurrence rate. Results Thirty-four patients were included in the study. Sixteen patients were randomly assigned to elective repair and 18 to conservative treatment. After 24 months, 8 patients (50%) assigned to elective repair compared to 14 patients (77.8%) assigned to conservative treatment had a complication related to the umbilical hernia or its repair. A recurrent hernia was reported in 16.7% of patients who underwent repair. For the secondary endpoint, quality of life through the physical (PCS) and mental component score (MCS) showed no significant differences between groups at 12 months of follow-up (mean difference PCS 11.95, 95% CI − 0.87 to 24.77; MCS 10.04, 95% CI − 2.78 to 22.86). Conclusion This trial could not show a relevant difference in overall morbidity after 24 months of follow-up in favor of elective umbilical hernia repair, because of the limited number of patients included. However, elective repair of umbilical hernia in patients with liver cirrhosis and ascites appears feasible, nudging its implementation into daily practice further, particularly for patients experiencing complaints. Trial registration Clinicaltrials.gov, NCT01421550, on 23 August 2011.

A CASE OF RUPTURED UMBILICAL HERNIA PRESENT CONCOMITANTLY WITH PROLAPSE OF THE OMENTUM DUE TO INTRACTABLE ASCITES IN AN ADULT

2010 ◽  
Vol 71 (1) ◽  
pp. 221-224
Author(s):  
Shunji KINUTA ◽  
Naoki KOSHIISHI ◽  
Masaru MATSUMURA ◽  
You HIRAI ◽  
Hiroshi WATANABE ◽  
...  
Keyword(s):  
Umbilical Hernia ◽  
Intractable Ascites
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