Ruptured umbilical hernia in cirrhotic patients: management with peritoneovenous shunting and herniorrhaphy

Acute rupture of an umbilical hernia in a patient with ascites carries a high nonoperative mortality but may be satisfactorily managed by emergency herniorrhaphy, as illustrated by the cases we have reported. Concomitant peritoneovenous shunting may also be done to obviate the ascitic cause of the hernia and prevent postoperative wound disruption.