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John P. Leonetti, MD; Gerard V. Aranha, MD; William A. Wilkinson, MD; Malcolm Stanley, MD; Herbert B. Greenlee, MD

Arch Surg. 1984;119(4):442-445.

Abstract
• During a ten-year period, 92 patients underwent an umbilical herniorrhaphy. Patients were divided into three groups: group 1, cirrhotic patients with ascites with functioning peritoneovenous shunts (n=15); group 2, cirrhotic patients with ascites with nonfunctioning or no peritoneovenous shunts (n = 24); and group 3, noncirrhotic patients (n = 53). The charts were analyzed for postoperative mortality and morbidity and recurrence of the umbilical hernia. Umbilical hernia in cirrhotic patients with uncontrolled ascites was associated with significant mortality (8.3%) and morbidity (16.6%) and a significantly greater incidence of recurrence (16.6%). Umbilical herniorrhaphy in patients with functioning peritoneovenous shunts was associated with minimal morbidity (7%). These data suggest that cirrhotic patients with ascites who require an umbilical herniorrhaphy preferably should undergo peritoneovenous shunting before repair of the hernia.

(Arch Surg 1984;119:442-445)

Author Affiliations
From the Medical (Dr Stanley) and Surgical (Dr Greenlee) Services, Hines (Ill) Veterans Administration Hospital, and the Department of Surgery (Drs Leonetti, Aranha, and Wilkinson), Loyola University Stritch School of Medicine, Maywood, Ill.

Footnotes
Accepted for publication Dec 15, 1983.

Read before the Seventh Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Airlie, Va, May 27, 1983.

Reprint requests to Department of Surgery, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153 (Dr Aranha).

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