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September 1960

Spontaneous Perforation of Umbilical Hernia: The Need for Early Herniorrhaphy in Ascites

Author Affiliations

New Haven, Conn.; Boston
Assistant Resident in Surgery (on leave), Peter Bent Brigham Hospital, Boston (Dr. Eisenberg). Attending Surgeon, West Roxbury Veterans Administration Hospital; Instructor in Surgery, Harvard Medical School (Dr. Hoye).

Arch Surg. 1960;81(3):514-516. doi:10.1001/archsurg.1960.01300030174023

Abdominal hernia as a concomitant of cirrhosis of the liver has been variously reported as having an incidence of between 16%1 and 42%,2 depending upon the presence of associated ascites. A reasonable hypothesis for the relationship has been offered by Altschule who has suggested that hernias form as a result of a long-standing increase in intra-abdominal pressure. In view of the observation that less than half of patients with large amounts of abdominal fluid form them, a latent congenital defect is a probable precursor.3 Although the commonly encountered hernias are either umbilical or inguinal, both may be found in the same patient.

The complications of untreated hernias of this nature are well known and include incarceration of the bowel, with or without strangulation. While spontaneous perforation of an umbilical hernia in infants (omphalocele) has from time to time been recorded in the English literature,4 the condition

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