Successful surgical management of ruptured umbilical hernias in cirrhotic patients

World Journal of Gastroenterology : WJG
Nikolaos A ChatzizachariasPaul Gibbs

Abstract

Acute umbilical hernia rupture in patients with hepatic cirrhosis and ascites is an unusual, but potentially life-threatening complication, with postoperative morbidity about 70% and mortality between 60%-80% after supportive care and 6%-20% after urgent surgical repair. Management options include primary surgical repair with or without concomitant portal venous system decompression for the control of the ascites. We present a retrospective analysis of our centre's experience over the last 6 years. Our cohort consisted of 11 consecutive patients (median age: 53 years, range: 36-63 years) with advanced hepatic cirrhosis and refractory ascites. Appropriate patient resuscitation and optimisation with intravenous fluids, prophylactic antibiotics and local measures was instituted. One failed attempt for conservative management was followed by a successful primary repair. In all cases, with one exception, a primary repair with non-absorbable Nylon, interrupted sutures, without mesh, was performed. The perioperative complication rate was 25% and the recurrence rate 8.3%. No mortality was recorded. Median length of hospital stay was 14 d (range: 4-31 d). Based on our experience, the management of ruptured umbilical hernias in patients ...Continue Reading

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Citations

Jul 28, 2016·World Journal of Gastrointestinal Surgery·Julio C U CoelhoCaroline Blum
May 5, 2017·Health Services Insights·Naeem AbbasBhavna Balar
Jul 13, 2017·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Miguel MalespinAmy D Lu
Mar 15, 2016·World Journal of Gastroenterology : WJG·Juan C Lopez-DelgadoCasimiro Javierre
Sep 25, 2020·Curēus·Muhammad Mubbashir SheikhMuhammad Hassaan Shahid
Jan 2, 2018·The American Journal of Emergency Medicine·Brit Long, Alex Koyfman
Dec 22, 2020·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Chenchen GuoJunsheng Li

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