Flood Syndrome: Spontaneous Rupture of Umbilical Hernia with Leakage of Ascitic Fluid
Keywords:
Flood Syndrome, Rupture of Umbilical HerniaAbstract
A 43-year-old man with disseminated tuberculosis and hepatitis B-related decompensated liver cirrhosis complicated by portal hypertension, esophageal varices, splenomegaly, and massive ascites was admitted with a seven-day history of progressive shortness of breath and sudden copious leakage of ascitic fluid following spontaneous rupture of an umbilical hernia.
On examination, he was hypotensive (blood pressure- 90/60 mmHg), mildly anemic, moderately icteric, had clubbing with bilateral pedal oedema. Abdomen was non-tender and distended with tense ascites. A large non-tender, non-reducible umbilical hernia (figure 1) was present with overlying skin being blackish and necrosed, accompanied by continuous leakage of ascitic fluid (figure 2).
We diagnosed the case as Flood syndrome, a rare complication of decompensated cirrhosis, characterized by spontaneous rupture of an umbilical hernia with external drainage of ascitic fluid. After hemodynamic stabilization, urgent surgical repair was done. Excision of umbilicus and anatomical repair was performed under subarachnoid block. His immediate postoperative condition improved; however, his clinical condition further deteriorated despite supportive management, and he died a few days after discharge.
J MEDICINE 2026; 27(2): 158
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