Umbilical hernia in a patient with ascites. Clinical case

Case Report


Abstract views: 46 / PDF downloads: 42

Authors

  • Guillermo Padrón Arredondo

DOI:

https://doi.org/10.58372/2835-6276.1108

Keywords:

Umbilical hernia, Cirrhosis, Incarceration, Rives-Stoppa technique

Abstract

INTRODUCTION. Since 1808, umbilical hernias were registered based on existing data, in such a way that 4716 scientific articles were registered in the last two centuries. About 6 to 14% of all abdominal wall hernias in adults are umbilical hernias with a prevalence of 2%.

CLINICAL CASE. A 47-year-old male came to the emergency room presenting with a giant umbilical hernia, liver cirrhosis and increased abdominal girth, fluid retention (ascites) to perform paracentesis of approximately 5 Liters, presenting confusion, asterixis, dyslalia, aphasia, upon admission. no coordination of walking. On physical examination, she was found to be hemodynamically unstable with the presence of ascitic fluid leakage through an ulcer caused by tension in the umbilical region; feverish peaks, for which reason a liquid sample was taken by puncture in the left iliac fossa, yellow in color and cloudy in appearance with glucose 106 mg/dL, LDH 239 mg/ml, presence of Hb (+++), and leukocytosis. He was evaluated for general surgery. Where a non-reducible incarcerated umbilical hernia was observed, it was decided to treat the complicated hernia, partial omentectomy plus ventral plasty with the Rives-Stoppa technique plus omphaloplasty with Drenovac-type closed drainage was performed without complications.

DISCUSSION. Cirrhotic patients who do not respond to medical treatments for ascites will require treatment such as serial therapeutic paracentesis. Large volume paracentesis (LVP), defined as the removal of more than 5 L of ascitic fluid, is an effective therapy for patients with tense ascites.

References

Patel S, Smiley A, Feingold C Khandehroo B, Kajmolli A, Latifi R. Chances of Mortality Are 3.5 Times Greater in Elderly Patients with Umbilical Hernia than in Adult Patients: An Analysis of 21,242 Patients. Int J Environment Res Publ Health. 2022; 19:10402

Salamone G, Licari L, Guercio G, Campanella S, Falco N, Gregorio Scerrino, et al. The abdominal wall hernia in cirrhotic patients: a historical challenge. World J Emerg Surg. 2018; 1:35 p.m. Doi .org/10.1186/ s13017-018-0196 -z .

Khatib S, Sabobeh T, Ahmed M, Abdalla K, Algeo E. Incarcerated Umbilical Hernia Following Therapeutic Paracentesis in a Cirrhotic Patient. Cureus. 2022; 14:4e23851. Doi 10.7759/cureus.23851.

Khatib S, Sabobeh T, Ahmed M, Abdalla K, Algeo E. Incarcerated Umbilical Hernia Following Therapeutic Paracentesis in a Cirrhotic Patient. Cureus. 2022; 14(4): e23851. Doi 10.7759/cureus.23851

Keat Tan H , Eu Chang P. Acute Abdomen Secondary to Incarcerated Umbilical Hernia after Treatment of Massive Cirrhotic Ascites, Hindawi Publishing Case Rep Hepatol. 2013, Article ID 948172, Doi. org/10.1155/2013/948172

Tsushimi T, Mori H, Nagase T, Harada T. Ikeda Y. A case of incarcerated umbilical hernia in an adult treated by laparoscopic surgery. J Surg Case Rep. 2015; 1-3. Doi: 10.1093/jscr/rjv001

Honmyo N, Kohashi T, Hakoda K, Oishi K, Nakashima A, Shintakuya Ret al. Spontaneous rupture of the umbilical vein associated with liver cirrhosis: A case report . Int J Surg Case Rep. 2021; 85:106183

Albeladi AM, Odeh AM, AlAli AH, Alkhars AM, Buhlaigah AM, Alghadeer HA, et al. Spontaneous Umbilical Hernia Rupture Associated with Omentum Evisceration in a Patient with Advanced Hepatic Cirrhosis and Refractory Ascites. Cureus. 2021; 13(6): e16042. Doi 10.7759/cureus.16042

Pinheiroa RS, Andrausa W, Waisberga DR, Nacifa LS, Ducattia L, Rocha-Santos V, et al. Abdominal hernias in cirrhotic patients: Surgery or conservative treatment? Results of a prospective cohort study in a high volume center: Cohort study. Ann Med Surg. 2020; 49:9-13. Doi.org/10.1016/j.amsu.2019.11.009 _

Mikolajczyk AE, Fung J, Sonali P, Chang B, Aronsohn AI. Herniated Umbilical Varix in a Patient with Cirrhosis. ACG Case Rep J. 2019; 6:1-2. Doi:10.14309/crj.0000000000000151

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Published

2023-11-25

How to Cite

Guillermo Padrón Arredondo. (2023). Umbilical hernia in a patient with ascites. Clinical case: Case Report. American Journal of Medical and Clinical Research & Reviews, 2(12), 1–5. https://doi.org/10.58372/2835-6276.1108

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