2021
DOI: 10.7759/cureus.16042
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Spontaneous Umbilical Hernia Rupture Associated With Omentum Evisceration in a Patient With Advanced Hepatic Cirrhosis and Refractory Ascites

Abstract: Flood syndrome is a spontaneous rupture of an umbilical hernia. It has a high mortality and morbidity and presents many challenges in medical versus surgical management. We present a case of a 23-year-old Yamani woman with complicated umbilical hernia, newly diagnosed hepatitis B infection, and decompensated liver cirrhosis with ascites (Child-Pugh grade B). The patient was undergoing multiple abdominal ascitic tapping that eventually ruptured with an omentum evisceration, causing Flood syndrome. An urgent umb… Show more

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Cited by 6 publications
(7 citation statements)
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“…All patients were male. The median MELD score was 19.5 (17)(18)(19)(20)(21)(22)(23)(24), 4 had Child-Pugh C cirrhosis, and 2 had CHILD PUGH B cirrhosis with a median score of 10.5 (7)(8)(9)(10)(11). Patient demographics and laboratory values at admission are visible in Tables 1 and 2.…”
Section: Resultsmentioning
confidence: 99%
See 1 more Smart Citation
“…All patients were male. The median MELD score was 19.5 (17)(18)(19)(20)(21)(22)(23)(24), 4 had Child-Pugh C cirrhosis, and 2 had CHILD PUGH B cirrhosis with a median score of 10.5 (7)(8)(9)(10)(11). Patient demographics and laboratory values at admission are visible in Tables 1 and 2.…”
Section: Resultsmentioning
confidence: 99%
“…There are no trials evaluating the safety and efficacy of a mesh repair in Flood syndrome. Though there has been an individual case report treating a perforate umbilical hernia with a mesh, 19 all other published series reports suggest a primary closure without mesh. 2,6,20,21 Chatzicharias 2 recommends the use of an absorbable mesh if a primary closure is not possible due to a large defect.…”
Section: Mesh or No Meshmentioning
confidence: 99%
“…Although using diuretics alone may not be a promising strategy, repeated therapeutic paracenteses may be necessary in the acute postoperative phase or when complicated with infection. Combining short-term drain placement [ 8 ], transjugular intrahepatic portocaval shunt placement [ 11 ] and peritoneovenous shunts [ 3 , 4 ] have been described previously. However, their utility is generally limited to specific indications in selected patients.…”
Section: Discussionmentioning
confidence: 99%
“…In the general population, UH has a prevalence of approximately 2%,4 while in cirrhotic patients with persistent ascites, it occurs in around 20% of the cases,5 or even up to 40% in large-volume ascites 6 7. As an extremely rare occurrence, though more frequent in cirrhotic patients with ascites,8–11 a sudden increase in intra-abdominal pressure (eg, coughing, straining, physical exercise, etc.) can rupture the UH sac, with leakage of ascites through a skin lesion, the so-called Flood Syndrome,12 or, in the worst-case scenario, with spontaneous bowel evisceration (SBE).…”
Section: Introductionmentioning
confidence: 99%