Chatzizacharias NA, Bradley JA, Harper S, Butler A, Jah A, Huguet E, Praseedom RK, Allison M, Gibbs P. Successful surgical management of ruptured umbilical hernias in cirrhotic patients. World J Gastroenterol 2015; 21(10): 3109-3113 [PMID: 25780312 DOI: 10.3748/wjg.v21.i10.3109]
Corresponding Author of This Article
Mr. Paul Gibbs, Consultant HPB and Transplant Surgeon, Department of HPB and Transplant Surgery, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom. paul.gibbs@addenbrookes.nhs.uk
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 14, 2015; 21(10): 3109-3113 Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.3109
Successful surgical management of ruptured umbilical hernias in cirrhotic patients
Nikolaos A Chatzizacharias, J Andrew Bradley, Simon Harper, Andrew Butler, Asif Jah, Emmanuel Huguet, Raaj K Praseedom, Michael Allison, Paul Gibbs
Nikolaos A Chatzizacharias, J Andrew Bradley, Simon Harper, Andrew Butler, Asif Jah, Emmanuel Huguet, Raaj K Praseedom, Michael Allison, Paul Gibbs, Department of HPB and Transplant Surgery, Addenbrooke’s Hospital, Cambridge CB2 0QQ, United Kingdom
J Andrew Bradley, NIHR Cambridge Biomedical Research Centre, Cambridge CB2 0QQ, United Kingdom
Michael Allison, Department of Hepatology, Addenbrooke’s Hospital, Cambridge CB2 0QQ, United Kingdom
Author contributions: All authors contributed in the writing of the manuscript; Chatzizacharias NA also accumulated and analysed the data.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mr. Paul Gibbs, Consultant HPB and Transplant Surgeon, Department of HPB and Transplant Surgery, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom. paul.gibbs@addenbrookes.nhs.uk
Telephone: +44-1223-257074 Fax: +44-1223-216015
Received: August 2, 2014 Peer-review started: August 2, 2014 First decision: August 15, 2014 Revised: September 11, 2014 Accepted: November 18, 2014 Article in press: November 19, 2014 Published online: March 14, 2015 Processing time: 226 Days and 15.2 Hours
Core Tip
Core tip: Acute umbilical hernia rupture in patients with hepatic cirrhosis and ascites is an unusual, but potentially life-threatening complication, with high morbidity and mortality. Management options include surgical repair with or without concomitant portal venous system decompression. Recent data suggested that the routine use of transjugular intrahepatic portosystemic shunt (TIPS) preoperatively in selected patients conferred improved perioperative and longer-term results. We present the successful management of 11 consecutive cases with only minor postoperative complications and no mortality. Based on our experience, the management of such cases is feasible without the use of TIPS routinely in the preoperative period, provided that meticulous patient optimisation is performed.
