SPONTANEOUS UMBILICAL HERNIA RUPTURE - REPORT OF 3 CASES

  • 1 January 1978
    • journal article
    • research article
    • Vol. 69  (6) , 689-693
Abstract
Three cases of spontaneous umbilical hernia rupture in patients with alcoholic liver disease and ascites are reported; 18 cases were previously reported in the literature. These 21 cases are reviewed in an attempt to determine precipitating events, prognostic factors, complications, and the results of therapy. All patients had significant ascites prior to umbilical rupture. Ulceration of the umbilicus prior to rupture was common (81%). The subsequent presence of peritonitis, hypotension, renal failure, gastrointestinal hemorrhage or hepatic coma was associated with significant mortality (80%). All patients with a serum albumin above 2.4 g/dl survived. There were no survivors in those patients who did not receive surgical treatment. Based upon the outcome of these 21 patients, optimal treatment of this disorder would seem to be early surgical repair of the umbilical hernia, appropriate fluid and electrolyte replacement, antibiotics and measures to reduce intraabdominal pressure.

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