scholarly journals A Case of Umbilical Hernia Causing Spontaneous Rupture due to Intractable Ascites with Liver Cirrhosis in an Adult

2020 ◽  
Vol 81 (11) ◽  
pp. 2351-2355
Author(s):  
Naoki SANO ◽  
Keichi YAMADA ◽  
Takanori UEDA ◽  
Tatsuya ODA
Keyword(s):  
Liver Cirrhosis ◽  
Spontaneous Rupture ◽  
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

Evisceration due to spontaneous rupture of umbilical hernia in adult

2021 ◽  
Author(s):  
Martín Adrián Bolívar-Rodríguez ◽  
Pedro Alejandro Magaña-Zavala ◽  
Adrián Pamanes-Lozano ◽  
Edgar Fragoza-Sánchez
Keyword(s):  
Spontaneous Rupture ◽  
Umbilical Hernia

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

Spontaneous rupture of an infantile umbilical hernia

1995 ◽  
Vol 82 (1) ◽  
pp. 35-35 ◽  
Author(s):  
I. M. Bain ◽  
H. M. Bishop
Keyword(s):  
Spontaneous Rupture ◽  
Umbilical Hernia

Spontaneous rupture of infantile umbilical hernia: report of three cases

1998 ◽  
Vol 18 (3) ◽  
pp. 239-241 ◽  
Author(s):  
A. Ahmed ◽  
M. Ahmed ◽  
P. T. Nmadu
Keyword(s):  
Spontaneous Rupture ◽  
Umbilical Hernia

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.

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