Management of Flood syndrome: What can we do better?

Table 1 Risk for herniation and possible hernia rupture establishment and prevention of umbilical hernia rupture/reoccurrence

Risk establishment	Prevention
Questions to ask
(1) Ascites control: (a) Changes in the abdomen volume; (b) Fluid balance; (c) Weight; (d) Use of prescribed treatment; (2) Nutrition (any signs of malnutrition?); (3) Alcohol intake; (4) Surgeries in the abdomen; (5) Pre-existing hernias; (6) Employment (heavy lifting activities); (7) Comorbidities; (8) Constipation; (9) Medicaments used; and (10) Changes in the abdomen, umbilical area visual appearance	(1) Education; (2) Risk establishment; and (3) Risk management: (a) Lifestyle modification; (b) Management of the underlying liver disease; (c) Management of ascites; (d) Doctor-patient communication; and (e) Communication between medical specialists
	Patients with UH
	(1) All the above; (2) Avoid heavy lifting, rapid movement; (3)Abdominal surgeon consult; and (4) Elective surgery in stable patients

UH: Umbilical hernia.