Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
Liver Int. 2022 Apr;42(4):871-878. doi: 10.1111/liv.15177. Epub 2022 Feb 17.
Polycystic liver disease (PLD) is related to hepatomegaly which causes an increased mechanical pressure on the abdominal wall. This may lead to abdominal wall herniation (AWH). We set out to establish the prevalence of AWH in PLD and explore risk factors.
In this cross-sectional cohort study, we assessed the presence of AWHs from PLD patients with at least 1 abdominal computed tomography or magnetic resonance imaging scan. AWH presence on imaging was independently evaluated by two researchers. Data on potential risk factors were extracted from clinical files.
We included 484 patients of which 40.1% (n = 194) had an AWH. We found a clear predominance of umbilical hernias (25.8%, n = 125) while multiple hernias were present in 6.2% (n = 30). Using multivariate analysis, male sex (odds ratio [OR] 2.727 p < .001), abdominal surgery (OR 2.575, p < .001) and disease severity according to the Gigot classification (Type 3 OR 2.853, p < .001) were identified as risk factors. Height-adjusted total liver volume was an independent PLD-specific risk factor in the subgroup of patients with known total liver volume (OR 1.363, p = .001). Patients with multiple hernias were older (62.1 vs. 55.1, p = .001) and more frequently male (22.0% vs. 50.0%, p = .001).
AWHs occur frequently in PLD with a predominance of umbilical hernias. Hepatomegaly is a clear disease-specific risk factor.
多囊性肝病（PLD）与肝肿大有关，这会导致腹部壁的机械压力增加。这可能导致腹壁疝（AWH）。我们旨在确定 PLD 中 AWH 的患病率，并探讨其危险因素。
在这项横断面队列研究中，我们评估了至少有 1 次腹部计算机断层扫描或磁共振成像扫描的 PLD 患者的 AWH 存在情况。两名研究人员独立评估了影像学上 AWH 的存在情况。从临床档案中提取了潜在危险因素的数据。
我们纳入了 484 名患者，其中 40.1%（n=194）存在 AWH。我们发现脐疝明显占主导地位（25.8%，n=125），而多发性疝占 6.2%（n=30）。使用多变量分析，男性（比值比[OR]2.727，p<.001）、腹部手术（OR2.575，p<.001）和根据 Gigot 分类的疾病严重程度（类型 3 OR2.853，p<.001）被确定为危险因素。在已知总肝体积的患者亚组中，身高调整后的总肝体积是 PLD 的独立特定危险因素（OR1.363，p=.001）。多发性疝患者年龄较大（62.1 岁 vs. 55.1 岁，p=.001），男性比例更高（22.0% vs. 50.0%，p=.001）。
AWH 在 PLD 中很常见，以脐疝为主。肝肿大是明确的疾病特异性危险因素。
