A Case of Ruptured Umbilical Hernia Repaired Under Local Anesthesia

Abstract

A 70-year-old man who had been receiving treatment for over 10 years for alcoholic liver cirrhosis, presented to our emergency department with sudden onset of leakage of ascites and abdominal tissue prolapse from the umbilical region. He was diagnosed as having a ruptured umbilical hernia with prolapse of the omentum, and prepared for emergency surgery. However, chest CT revealed severe pneumonia, which was considered as a contraindication for general anesthesia; therefore, we performed the hernia repair under local anesthesia. At surgery, the prolapsed omentum was protectively reduced into the abdominal cavity, and the hernial orifice was closed by simple suture. After the surgery, ascitic fluid leakage through the drain placed under the skin continued at the rate of ≥ 1,000 mL/day. Therefore, cell-free and concentrated ascites reinfusion therapy was initiated, following which the drainage volume gradually reduced, the drain was removed on postoperative day 8, and the patient was discharged. Umbilical hernia rupture is rare, with only a few reported cases. We report a case of umbilical hernia rupture that was repaired under local anesthesia.