The Teaching Point

Incarceration of the umbilical hernia is a rare but potentially serious complication of large volume paracentesis, and therefore, it is recommended that patients be examined closely for the presence of umbilical hernias before removal of ascitic fluid. If a hernia is present, the physician should be aware of this complication and an attempt should be made for external reduction of easily reducible hernias. Close follow up to assess for symptoms of a complicated hernia sac should be done post LVP. Elective surgical repair of the hernia is also recommended when optimal control of ascites is achieved.






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Incarceration of umbilical hernia: a rare complication of large volume paracentesis

Free full text article: Incarceration of umbilical hernia: a rare complication of large volume paracentesis

Abstract
We present two cases of umbilical hernia incarceration following large volume paracentesis (LVP) in patients with cirrhotic ascites. Both patients became symptomatic within 48 hours after the LVP. Although being rare, given the significantly higher mortality rate of cirrhotic patients undergoing emergent herniorrhaphy, this complication of LVP is potentially serious. Therefore, it is recommended that patients be examined closely for the presence of umbilical hernias before removal of ascitic fluid and an attempt should be made for external reduction of easily reducible hernias, if a hernia is present.






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