Ruptured adult umbilical hernia caused by intractable ascites associated with liver cirrhosis

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  • KUBO Toru
    Department of Surgery, Japan Self Defense Forces Hospital Yokosuka
  • OKUSA Yasushi
    Department of Surgery, Japan Self Defense Forces Hospital Yokosuka

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  • 肝硬変に伴う難治性腹水から発症した成人臍ヘルニア破裂の1例
  • 症例 肝硬変に伴う難治性腹水から発症した成人臍ヘルニア破裂の1例
  • ショウレイ カンコウヘン ニ トモナウ ナンチセイ フクスイ カラ ハッショウ シタ セイジンセイヘルニア ハレツ ノ 1レイ

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A 50-year-old man who had been treated for alcoholic cirrhosis as an outpatient became to have increasing ascites from the beginning of 2010 and administration of diuretics failed to control it. At the same time, a bulge formed around the umbilicus and then the patient had been followed under a diagnosis of umbilical hernia. In September 2010, watery discharge began to leak from the umbilicus for 3 hours when the patient was seen at our hospital, and his body weight had decreased by about 10 kg. The abdomen remarkably distended with ascites, and top of the umbilical hernia associated an ulcer and bulging reached infant's head size. A contrast-enhanced abdominal CT scan visualized massive ascites and part of the intestine as the hernia contents. The herniated intestine was voluntarily reduced, and surgery was scheduled because his general condition was stable. At surgery, the herniated portion was resected under general anesthesia and mesh (Ultrapro Hernia System® : UHS) was inserted for the surgical defect. The postoperative course was uneventful and the patient was discharged. There have been no signs of recurrence as of one year after the operation.<BR>Adult umbilical hernias are comparatively rare and only few cases of perforated adult umbilical hernia have been encountered in the literature so far.

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