Abstract
Inguinal hernia in patients with cirrhosis and ascites presents extra surgical challenges because of impaired coagulation, malnutrition, portal hypertension as well as poor wound healing. We report a 66-year-old man who presented with a gradually increasing left groin swelling for 15 days. The swelling was associated with dragging discomfort. The swelling was more prominent on standing, coughing and straining. Examination showed a reducible left inguinal swelling with a positive cough impulse. Investigations showed thrombocytopenia, hypoalbuminemia and slightly prolonged prothrombin time. Ultrasonography revealed cirrhotic liver changes, ascites and a left inguinal hernia. An elective open hernia repair was performed after optimization of patient status. Intraoperatively, the hernial sac contained approximately 500 mL of ascitic fluid. Tension-free polypropylene mesh repair was performed. The postoperative period was uneventful. An elective inguinal hernia repair might be safely done in selected cirrhotic patients after adequate preoperative optimization as well as ascites control.
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