Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

Hdl Handle:
http://hdl.handle.net/10147/129742
Title:
Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report
Authors:
Good, Daniel W; Royds, Jonathan; Smith, Myles J; Neary, Paul C; Eguare, Emmanuel
Citation:
Journal of Medical Case Reports. 2011 May 03;5(1):170
Issue Date:
3-May-2011
URI:
http://hdl.handle.net/10147/129742
Abstract:
Abstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.
Item Type:
Journal Article

Full metadata record

DC FieldValue Language
dc.contributor.authorGood, Daniel W-
dc.contributor.authorRoyds, Jonathan-
dc.contributor.authorSmith, Myles J-
dc.contributor.authorNeary, Paul C-
dc.contributor.authorEguare, Emmanuel-
dc.date.accessioned2011-05-18T10:35:42Z-
dc.date.available2011-05-18T10:35:42Z-
dc.date.issued2011-05-03-
dc.identifierhttp://dx.doi.org/10.1186/1752-1947-5-170-
dc.identifier.citationJournal of Medical Case Reports. 2011 May 03;5(1):170-
dc.identifier.urihttp://hdl.handle.net/10147/129742-
dc.description.abstractAbstract Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.-
dc.titleUmbilical hernia rupture with evisceration of omentum from massive ascites: a case report-
dc.typeJournal Article-
dc.language.rfc3066en-
dc.rights.holderGood et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2011-05-16T10:04:18Z-
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