Ginsburg Beth Y, Sharma Adhi N
Department of Emergency Medicine, New York University School of Medicine, New York, New York 10016, USA.
J Emerg Med. 2006 Feb;30(2):155-7. doi: 10.1016/j.jemermed.2005.05.017.
Umbilical hernias are a common complication of persistent ascites. Spontaneous rupture of these hernias is a less common complication. We report a case of spontaneous evisceration through an umbilical hernia in a cirrhotic patient with chronic ascites. Definitive surgical repair of the evisceration was not possible secondary to persistent ascites that was refractory to paracentesis and diuresis. Transjugular intrahepatic portocaval shunt (TIPS) placement was ultimately performed in an attempt to eliminate the ascites fluid. This case demonstrates a rare, but life-threatening complication of abdominal ascites that may be prevented by aggressive medical and surgical management.
脐疝是持续性腹水的常见并发症。这些疝的自发性破裂是一种较不常见的并发症。我们报告一例患有慢性腹水的肝硬化患者通过脐疝发生自发性内脏脱出的病例。由于持续性腹水对穿刺放液和利尿治疗无效，无法对内脏脱出进行确定性手术修复。最终进行了经颈静脉肝内门体分流术（TIPS）置放，试图消除腹水。该病例表明了一种罕见但危及生命的腹水并发症，积极的内科和外科治疗可能预防这种并发症。
