Flood syndrome is a rare complication of cirrhosis of liver accompanied by ascites and a sudden rupture of umbilical hernia causing drainage of ascitic fluid from abdominal cavity. We report management of a case of Flood syndrome which was caused by rupture of incisional hernia. The clinical picture was similar to well described and widely accepted Flood syndrome. A 70-year-old female with decompensated hepatitis C cirrhosis was transported to the emergency department with a sudden drainage of ascitic fluid after sudden dehiscence of pre-existing incisional hernia and diffuse abdominal tenderness. Initially, she was managed by applying ostomy bag and diuretics to reduce the ascites. On 8th day of admission, a 16 Fr. drain was percutaneously placed in the left lower abdominal quadrant to divert the fluid from the abdominal wall defect. On 13th day, 80% partial splenic embolization (PSE) was attempted to control portal hypertension to reduce the ascites volume. After PSE, the hepatic venous pressure gradient reduced from 28 to 21cm H 2 O. The peritoneal drain was removed on 16th day and she was discharged on 22nd day. We conclude that PSE and temporary percutaneous peritoneal drainage are useful option to manage Flood syndrome.

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Injection sclerotherapy was performed in two patients with esophageal varices who had undergone a total gastrectomy and Roux‐en‐ Y esophagojejunostomy for gastric cancer. Both of the patients were diagnosed as having postnecrotic liver cirrhosis due to serum hepatitis. The first patient developed esophageal varices after surgery. The second patient had recurrent esophageal varices after surgery for both gastric cancer and the esophageal varices. Five percent ethanolamine oleate was the sclerosant used together with the contrast medium iopamidol (5% EOI). After intravariceal injection, the flow of the sclerosant was followed by fluoroscopy. The esophageal varices were fed by the branches of the jejunal vein of the arcade of the ascending jejunal limb. The esophageal varices and branches of the jejunal vein were destroyed by three consecutive sessions of sclerotherapy. No complications occurred during or after the therapy. Therefore, injection sclerotherapy, along with varicealography, is one of the most effective methods of treating esophageal varices arising after a total gastrectomy.

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