Abstract
We have encountered a case of an incarcerated adult umbilical hernia that developed consequent to drainage of voluminous ascites via paracentesis, and herein we report the details. The patient was a 51-year-old woman. One month previously she had felt abdominal distension and noticed bulging of her abdomen. She consulted a neighboring doctor who diagnosed the case as stagnant ascites due to liver cirrhosis. About six liters of ascitic fluid were drained, but on the following day a swelling appeared in the umbilical region, she felt abdominal pain and was thus transferred to our hospital. By means of abdominal ultrasonography and computerized tomography scanning, we diagnosed her as having strangulation of the ileus due to impaction of intestinal loops inside the sac of an umbilical hernia, and consequently an emergency operation was performed. Although the ileum was incarcerated, an improvement in the blood flow to the ileum was noticed upon loosening the hernial orifice, and hence resection of the ileum was considered unnecessary. We think that in our present case, the umbilical hernia developed due to the sudden decrease in the ascitic fluid, which was induced by drainage of voluminous ascites on the preceding day.
