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Revista argentina de cirugía

On-line version ISSN 2250-639X

Abstract

CANO, Carlos A.  and  ARIAS, Abraham R.. Umbilical hernia in cirrhotic patients: conservative treatment or surgery?. Rev. argent. cir. [online]. 2021, vol.113, n.1, pp.83-91. ISSN 2250-639X.  http://dx.doi.org/10.25132/raac.v113.n1.1506.ei.

Background:

Background: Ascites is a common complication in patients with cirrhosis, and elevated intraabdominal pressure can lead to the development of abdominal wall hernias, particularly in patients with latent umbilical defects.

Objectives:

The aim of this study was to report the incidence and benefits of elective surgery for the management of umbilical hernias in cirrhotic patients with ascites.

Material and methods:

Between January 2015 and January 2019 15 patients with symptomatic umbi lical hernia underwent elective surgery in a public hospital; 100% were men with a history of alcoho lism and were hospitalized due to liver cirrhosis. The defect was closed, and a polypropylene mesh was placed in the supra-aponeurotic plane in most cases.

Results:

The preoperative risk was estimated using the Child-Pugh score. Ascites was evacuated in all the cases. Patients were followed-up every 30 days during the first 6 months and then twice a year. There were no hernia recurrences. Two patients were lost to follow-up 12 months after surgery and 1 patient died 9 months after the procedure due to progression of cirrhosis.

Conclusions:

Patients with liver cirrhosis and umbilical hernia should undergo elective surgery. Wat chful waiting is associated with higher risk of hernia rupture and high morbidity and mortality.

Keywords : Umbilical hernia; Hepatic cirrhosis; Ascites.

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