title: Prognosis elements in surgical treatment of complicated umbilical hernia in patients with liver cirrhosis.
abstract: BACKGROUND
  The surgical treatment of umbilical hernia in cirrhosis patients raises special management challenges. The attitude upon the repair of these hernias varies from expectancy or elective treatment in early stages of the disease to the surgical treatment only if complications occur.
  
  
  METHODS
  We have assessed 22 consecutive cases of cirrhosis patients treated for complicated umbilical hernia in the Surgical Department of "Sf. Pantelimon" Emergency Hospital in Bucharest between January 2008 and December 2012. The patients' stratification was done in stages of liver disease based upon Child-Pugh classification. Complications that required emergency repair were the following: strangulation, incarceration and hernia rupture. The postoperative complications were ordered in five grades of severity based upon Clavien classification.
  
  
  RESULTS
  The severity of the complications was higher in advanced stages of liver cirrhosis, Child B and C. There were 5 deaths representing 22,7%, four of them in patients with Child C disease stage.
  
  
  CONCLUSIONS
  The incidence of morbidity and mortality after umbilical hernia repair in emergencies increases in advanced stages of liver cirrhosis. It is advisable to prevent complications occurrence and perform surgical repair of umbilical hernia in elective condition.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest; General Surgery Department, "Sf. Pantelimon" Emergency Hospital, Bucharest.
authors.forename: P
authors.initials: P
authors.lastname: Banu
authors.forename: F
authors.initials: F
authors.lastname: Popa
authors.forename: V D
authors.initials: VD
authors.lastname: Constantin
authors.forename: C
authors.initials: C
authors.lastname: Bălălău
authors.forename: M
authors.initials: M
authors.lastname: Nistor
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006554:Hernia, Umbilical / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis
keywords: complications; liver cirrhosis; umbilical hernia