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. 2022 Oct;92(10):2524-2528.
doi: 10.1111/ans.17936. Epub 2022 Jul 23.

A novel approach to managing ruptured umbilical hernias in cirrhosis

Romain Seppey  1 , Aditya Benjamin  1 , Paul Lambrakis  1   2
Affiliations

A novel approach to managing ruptured umbilical hernias in cirrhosis

Romain Seppey et al. ANZ J Surg. 2022 Oct.

Abstract

Background: Ruptured umbilical hernias in patients with ascites (Flood Syndrome) is an uncommon problem with high morbidity and mortality. The treatment of patients experiencing Flood Syndrome is controversial, with a multitude of different treatments being proposed.

Method: This paper presents our experience in treating Flood syndrome, and presents a standardized way of treating these patients.

Results: Six consecutive patients with Flood syndrome were treated with the same standardized management and surgical technique. All patients had Cirrhosis (Child B and C). All were treated as open emergency operations, with no recurrence or post-operative complications.

Conclusion: Though there is a lack of level I or II evidence, the data suggests that ruptured umbilical hernias in cirrhotic patients are a surgical emergency that can be optimally managed with operative management. We present a standardized technique for the repair of these hernias which is simple, reliable and appears to have reproducible results. The technique aims to provide a hermetic seal immediately peri-operatively and is supported by medical optimization of the post-operative period. Our small case series represents effective and safe management in appropriately selected patients.

Keywords: emergency surgery; hernia.

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References

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