A case of ruptured umbilical hernia present concomitantly with prolapse of the omentum due to intractable ascites in an adult

Abstract

A 54-year-old man, with alcoholic cirrhosis and intractable ascites was admitted due to leakage of massive amounts of ascites. An abdominal CT showed rupture of the umbilical hernia and prolapse of the omentum. Emergency surgery was required. The prolapsed omentum was resected ; a 2 cm in diameter hernial orifice and massive ascites were found in the peritoneal cavity. An indwelling drain was placed into the peritoneal cavity, and the hernial orifice was closed. Postoperatively, the ascitic fluid was drained via the indwelling drain to decrease tension on the hernial orifice. There were no complications, and the patient was discharged.
In adults rupture of an umbilical hernia is very rare. Only four cases, including our case, have been reported in Japan to date. In only two of these cases Moreover, intra-abdominal organ prolapse was present concomitantly.