Incarcerated umbilical hernia leading to small bowel ischemia.
A 59-year-old male with history of hepatitis C, refractory ascites requiring multiple paracentesis and transjugular intrahepatic portosystemic shunt placement presented to the emergency department with 2 days of abdominal pain. Physical examination revealed blood pressure of 104/66 and pulse of 94. The abdomen was remarkable for distention and a tender incarcerated umbilical hernia. The skin overlying the hernia was pale with areas of necrosis. The patient immediately underwent laparotomy which was successful.
Department of Emergency Services, VA New York Harbor Healthcare Center, New York, United States. nancy.lutwak@gmail.com
Nancy
N
Lutwak
Curt
C
Dill
D001201:Ascites / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000628:therapy; D006554:Hernia, Umbilical / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D019168:Portasystemic Shunt, Transjugular Intrahepatic