SHM Converge Scientific Abstract ePoster Gallery-Flood Syndrome: A Rare Complication of Decompensated Cirrhosis

Pdf Summary

Flood syndrome is a rare but serious complication of decompensated cirrhosis with ascites. This case describes a 68-year-old patient with end-stage liver disease who presented after stopping diuretics and developed worsening abdominal distension, a large umbilical hernia, and ulcerated skin with clear yellow fluid drainage. CT imaging showed a fascial defect with nonobstructed bowel within the hernia. Labs and ascitic fluid studies confirmed portal hypertension and advanced liver disease.<br /><br />The patient underwent therapeutic paracentesis and was admitted for management of decompensated cirrhosis. Because of concern for impending spontaneous rupture and Flood syndrome, General Surgery was consulted urgently and performed hernia repair with umbilicoplasty. Her hospital course was complicated by recurrent large-volume paracenteses, spontaneous bacterial peritonitis, and transjugular intrahepatic portosystemic shunt (TIPS) placement.<br /><br />The report emphasizes that longstanding ascites can lead to umbilical hernias in about 20% of patients, and skin breakdown over the hernia may progress to spontaneous rupture with ascitic fluid leakage. Flood syndrome carries high morbidity and a mortality rate around 30%, due to complications such as infection, bowel incarceration, and hypotension. Since most cases are preceded by skin ulceration or necrosis, visible skin compromise over an umbilical hernia in patients with ESLD should prompt urgent surgical evaluation and consideration of operative repair.

Asset Subtitle

Meygan J. Lackey Elway

Meta Tag

Author List Meygan J. Lackey Elway, Patricia Giunta

Category Clinical Vignettes

Concept Flood Syndrome

Concept Cirrhotic Ascites

Concept Decompensated Cirrhosis

Concept Umbilical Hernia

Concept Ascitic Fluid Leakage

Distinguished Non-Finalist

Presenter Organization Boston University/Boston Medical Center

Presenting Author Meygan J. Lackey Elway

Track Adult

Keywords

Flood syndrome

decompensated cirrhosis

ascites

umbilical hernia

end-stage liver disease

spontaneous rupture

ascitic fluid leakage

hernia repair

spontaneous bacterial peritonitis

TIPS

Flood Syndrome

Cirrhotic Ascites

Decompensated Cirrhosis

Umbilical Hernia

Ascitic Fluid Leakage