Flood Syndrome and Portal Vein Thrombosis: An Unusual Complication of Liver Cirrhosis
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Abstract
Spontaneous paracentesis is a life-threatening complication of liver cirrhosis. Importance of precise and early identification cannot be overstated, as early treatment improves the prognosis and survival. A 78-year-old woman with cirrhosis presented with ascitic fluid gushing out from an umbilical hernia. The patient received intravascular repletion with intravenous albumin, antibiotics, and rapid umbilical herniorrhaphy. Post-operatively, the patient experienced acute kidney injury and portal vein thrombosis, which was corrected with electrolyte replacement and transjugular intrahepatic portosystemic shunt with thrombectomy. The patient recovered completely and was discharged without difficulty.
[1]Lerner S, Rost MS. Spontaneous abdominal paracentesis. JAMA. 1959, 170(11):1310-1311. https://doi.org/10.1001/ jama.1959.63010110004011b
[2]Flood F. Spontaneous perforation of the umbilicus in Laennec’s cirrhosis with massive ascites. New Engl J Med. 1961, 264:72-4. https://doi.org/10.1097/maj.0b013e3181f31932
[3]Coelho JCU, Claus CMP, Campos ACL, Costa MAR, Blum C. Umbilical hernia in patients with liver cirrhosis: A surgical
challenge. World J Gastrointest Surg. 2016, 8(7):476-482. https://doi.org/10.4240/wjgs. v8. i7.476
[4]Srivastava KS. A continuous leak from within: A case report on Flood syndrome. Journal of Surgical Case Reports. 2022, 2: rjac011. https://doi.org/10.1093/jscr/rjac011
[5]Nguyen ET, Tudtud-Hans LA. Flood syndrome: Spontaneous umbilical hernia rupture leaking ascitic fluid - a case report. Perm J. 2017, 21:16-152. https://doi.org/10.7812/TPP/16-152
[6] Murruste M, Kase K, Kivilo M, Lepner U. Flood syndrome following right-sided heart failure: A case report. J Surg Case Rep. 2022, 1: rjab631. https://doi.org/10.1093/jscr/rjab631.
[7] DeLuca IJ, Grossman ME. Flood syndrome. JAAD. 2015, 1(1):5- 6. https://doi.org/10.1016/j.jdcr.2014.09.003
[8]Belli G, D’Agostino A, Fantini C, Cioffi L, Belli A, Russolillo N, et al. Laparoscopic incisional and umbilical hernia repair in cirrhotic patients. Surg Laparosc Endosc Percutan Tech. 2006, 16(5):330- 333. https://doi.org/10.1097/01.sle.0000213745.15773.c1
[9] Chatzizacharias NA, Bradley JA, Harper S, Butler A, Jah A, Huguet E, et al. Successful surgical management of ruptured umbilical hernias in cirrhotic patients. World J Gastroenterol. 2015, 21(10):3109–3113. https://doi.org/10.3748/wjg. v21. i10.3109
[10] Fusullo M, Oranefo J. A rare case of Flood syndrome and a perspective on management. American Journal of Gastroenterology. 2017, 112: S125.
[11] Choo E, McElroy S. Spontaneous bowel evisceration in a patient with alcoholic cirrhosis and an umbilical hernia. J Emerg Med. 2008, 34(1):41–43. https://doi.org/10.1016/j.jemermed.2007.03.035
[12] Long WD, Hayden GE. Man with rushing fluid from his umbilicus. Annals of Emergency Medicine. 2013, 62(4):431. https://doi.org/10.1016/j.annemergmed.2013.02.026
[13] Liu GF, Srinivasan A, Mutnuri S, Yerramadha MR, Agraharkar M. Acute abdomen from umbilical hernia rupture to flood syndrome: A case report and review of literature. J Med Cases. 2019, 10(10):309-311. https://doi.org/10.14740/jmc3375
[14] Chikamori F, Mizobuchi K, Ueta K, Takasugi H, Yukishige S, Matsuoka H, et al. Flood syndrome managed by partial splenic embolization and percutaneous peritoneal drainage. Radiol Case Rep. 2021, 16(1): 108-112. https://doi.org/10.1016/j.radcr.2020.10.045
[15] Strainiene S, Peciulyte M, Strainys T, Stundiene L, Savlan I, Liakina V, et al. Management of Flood syndrome: What can we do better? World J Gastroenterol. 2021, 27(32): 5297-5305. https://doi.org/10.3748/wjg. v27.i32.5297
[2]Flood F. Spontaneous perforation of the umbilicus in Laennec’s cirrhosis with massive ascites. New Engl J Med. 1961, 264:72-4. https://doi.org/10.1097/maj.0b013e3181f31932
[3]Coelho JCU, Claus CMP, Campos ACL, Costa MAR, Blum C. Umbilical hernia in patients with liver cirrhosis: A surgical
challenge. World J Gastrointest Surg. 2016, 8(7):476-482. https://doi.org/10.4240/wjgs. v8. i7.476
[4]Srivastava KS. A continuous leak from within: A case report on Flood syndrome. Journal of Surgical Case Reports. 2022, 2: rjac011. https://doi.org/10.1093/jscr/rjac011
[5]Nguyen ET, Tudtud-Hans LA. Flood syndrome: Spontaneous umbilical hernia rupture leaking ascitic fluid - a case report. Perm J. 2017, 21:16-152. https://doi.org/10.7812/TPP/16-152
[6] Murruste M, Kase K, Kivilo M, Lepner U. Flood syndrome following right-sided heart failure: A case report. J Surg Case Rep. 2022, 1: rjab631. https://doi.org/10.1093/jscr/rjab631.
[7] DeLuca IJ, Grossman ME. Flood syndrome. JAAD. 2015, 1(1):5- 6. https://doi.org/10.1016/j.jdcr.2014.09.003
[8]Belli G, D’Agostino A, Fantini C, Cioffi L, Belli A, Russolillo N, et al. Laparoscopic incisional and umbilical hernia repair in cirrhotic patients. Surg Laparosc Endosc Percutan Tech. 2006, 16(5):330- 333. https://doi.org/10.1097/01.sle.0000213745.15773.c1
[9] Chatzizacharias NA, Bradley JA, Harper S, Butler A, Jah A, Huguet E, et al. Successful surgical management of ruptured umbilical hernias in cirrhotic patients. World J Gastroenterol. 2015, 21(10):3109–3113. https://doi.org/10.3748/wjg. v21. i10.3109
[10] Fusullo M, Oranefo J. A rare case of Flood syndrome and a perspective on management. American Journal of Gastroenterology. 2017, 112: S125.
[11] Choo E, McElroy S. Spontaneous bowel evisceration in a patient with alcoholic cirrhosis and an umbilical hernia. J Emerg Med. 2008, 34(1):41–43. https://doi.org/10.1016/j.jemermed.2007.03.035
[12] Long WD, Hayden GE. Man with rushing fluid from his umbilicus. Annals of Emergency Medicine. 2013, 62(4):431. https://doi.org/10.1016/j.annemergmed.2013.02.026
[13] Liu GF, Srinivasan A, Mutnuri S, Yerramadha MR, Agraharkar M. Acute abdomen from umbilical hernia rupture to flood syndrome: A case report and review of literature. J Med Cases. 2019, 10(10):309-311. https://doi.org/10.14740/jmc3375
[14] Chikamori F, Mizobuchi K, Ueta K, Takasugi H, Yukishige S, Matsuoka H, et al. Flood syndrome managed by partial splenic embolization and percutaneous peritoneal drainage. Radiol Case Rep. 2021, 16(1): 108-112. https://doi.org/10.1016/j.radcr.2020.10.045
[15] Strainiene S, Peciulyte M, Strainys T, Stundiene L, Savlan I, Liakina V, et al. Management of Flood syndrome: What can we do better? World J Gastroenterol. 2021, 27(32): 5297-5305. https://doi.org/10.3748/wjg. v27.i32.5297
| Files | ||
| Issue | Vol 8 No 3 (2023): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v8i3.14238 | |
| Keywords | ||
| Flood syndrome Ascites Umbilical hernia Liver cirrhosis Paracentesis | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Abbasi A, Hong P, Marinkovic A, Sanyaolu A, Enofe I. Flood Syndrome and Portal Vein Thrombosis: An Unusual Complication of Liver Cirrhosis. CRCP. 2023;8(3):121-125.
