Flood Syndrome: Endovascular management of spontaneous rupture of an umbilical hernia due to long-standing ascites - A case report

J Radiol Case Rep. 2023 Aug 31;17(8):29-37. doi: 10.3941/jrcr.v17i8.4884. eCollection 2023 Aug.

Abstract

Umbilical hernias are common in patients with cirrhosis of the liver and ascites; however, spontaneous rupture of the hernia is a rare complication. Flood Syndrome occurs very rarely in cirrhotic patients with massive ascites and refers to the spontaneous rupture of an umbilical hernia followed by leakage of ascites fluid. A literature search shows that patients have been managed both operatively and nonoperatively for this condition. We report a case of a 56-year-old man with a history of alcohol-related liver cirrhosis and massive ascites refractory to medical therapy with sudden and spontaneous perforation of his hernia leading to drainage of ascitic fluid from the abdomen. We performed a transjugular intrahepatic portosystematic shunt to relieve portal pressure and subsequent intraabdominal pressure. The patient had resolution of symptoms and the ascitic fluid outflow was resolved.

Keywords: ascites; cirrhosis; flood syndrome; tips; umbilical hernia.

Publication types

  • Case Reports

MeSH terms

  • Ascites / diagnostic imaging
  • Ascites / etiology
  • Ascites / surgery
  • Endovascular Procedures*
  • Floods
  • Hernia / complications
  • Hernia, Umbilical* / complications
  • Hernia, Umbilical* / diagnostic imaging
  • Hernia, Umbilical* / surgery
  • Humans
  • Male
  • Middle Aged
  • Rupture, Spontaneous
  • Syndrome