Results of repair of spontaneously ruptured umbilical hernia in cirrhotic patients with ascites

The aim of this work was to revise the results of the repair of spontaneously ruptured umbilical hernia in cirrhotic patients using prolene mesh only on urgent bases and to compare it to the results of other works dealing with the same complication in umbilical hernia using the same or other techniques. The study included 21 patients, 17 males and four females with ages ranging between 35 and 67 years [average 52 years] complaining of longstanding history of chronic liver disease with ascites. All the patients were rapidly prepared and operated upon immediately by hernioplasty using prolene mesh. There were two deaths of liver cell failure, one patient passed into hepatic encephalopathy from which he recovered after intensive medical therapy and three patients had wound infection which were managed by repeated culture and sensitivity with giving the proper antibiotic and frequent dressings. Follow up period from one month to 1.5 years revealed no recurrences. The use of hernioplasty as an emergency procedure in ruptured umbilical hernia in cirrhotic patients with ascites gives the same results as regard the mortality and the morbidity

One stage resection of acute sigmoid volvulus

In a descriptive prospective study, 20 patients with sigmoid volvulus and two with ileosigmoid knotting had primary resection of the redundant sigmoid colon with an immediate anastomosis after intraoperative antegrade colonic irrigation. Tube caecostomy was established in the two patients who required resection of both small bowel and sigmoid colon and in a further five patients in whom the integrity of the colorectal anastomosis was suspected. There was no clinical anastomosis leak and no mortality in any of the patients. Superficial wound infection occurred in three patients. The duration of hospital stay ranged from 10 to 14 days. The result showed that the procedure was associated with an acceptable morbidity and a short hospital stay. Also, it suggested that the resection of acute sigmoid volvulus and primary anastomosis after antegrade intraoperative colonic lavage safely provided that the patient is reasonably fit