Effect of increased intra-abdominal pressure due to pneumoperitoneum on liver functions and liver histopathology in a rat model with intra-abdominal sepsis

Intra-abdominal sepsis was induced by open cecal ligation and puncture [OCLP] technique. Sixty rats were randomly divided into three equal groups each of 20. G1 was used as a control. G2 were subjected to laparotomy and closure after 12 hours from [OCLP] via the same incision. In G3, pneumoperitoneum was induced 12 hours after OCLP and maintained at 12 mmHg for about 30 minutes. Blood samples were taken for liver functions after 12 and 24 hours from OCLP procedure, and Liver biopsies were taken for histopathological examination after 24 hours. The results showed that liver functions were markedly increased in G3 after pneumoperitoneum, compared to Gs 1 and 2. The histopathological changes in liver biopsies due to sepsis were more marked in cases exposed to pneumoperitoneum than that exposed to conventional laparotomy. The intra-abdominal sepsis affected liver functions and caused pathogenesis. The increased intra-abdominal pressure induced more liver insults, compared to that gained after open surgery

Mesh repair of non-complicated umbilical hernia in ascitic patients with liver cirrhosis

The policy of elective repair of umbilical hernia in cirrhotic ascetic patients has long been a subject of debate and is still a major health problem. This study evaluated the role and outcome of elective mesh repair of umbilical hernia in cirrhotic ascetic patients, compared with the conventional two layers fascial repair technique. Forty cases with a small to medium sized umbilical hernia defects in ascetic cirrhotic patients were divided into two groups [GI and GII] of 20 patients each. After proper control of ascites in both groups, patients in GI were subjected to elective umbilical hernia onlay mesh repair. In GII, hernia were managed by conventional two layers fascial repair. In GI, transient early postoperative ascetic fluid leakage occurred in 3 [15%] cases and mild superficial wound infection in 5 [25%] cases which was controlled by antibiotics. Two [10%] cases developed hernia recurrence during follow up period. In GII, ascetic leakage occurred in 6 [30%] cases that responded well to conservative management except only one case needed re-exploration and repair reinforcement. Drainage was significantly less than in GI in among [P