# Understanding the Spectrum of Flood Syndrome: A Case Series

## TL;DR

This paper presents six cases of ruptured umbilical hernias in patients with liver cirrhosis and ascites, showing a surgical approach with good outcomes based on liver disease severity scores.

## Contribution

The study introduces a standardized surgical protocol for managing Flood syndrome and correlates liver disease scores with postoperative outcomes.

## Key findings

- A standardized protocol of primary anatomic repair and drain placement was used for six patients with Flood syndrome.
- Child-Turcotte-Pugh and MELD scores were found to correlate with postoperative outcomes in these patients.
- The surgical technique showed good outcomes for patients with favorable liver disease severity scores.

## Abstract

Flood syndrome refers to ruptured umbilical hernias in patients with chronic ascites with underlying liver cirrhosis. These ruptures may introduce infection into the abdomen and hence require emergency surgery. However, these patients are at high risk during these procedures owing to coagulopathy, hypotension and electrolyte imbalances. In our series, we describe six patients who presented with varying degrees of severity and were treated with a standardised protocol of primary anatomic repair and drain placement. Furthermore, we assessed the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores in these patients and correlated them to postoperative outcomes. This surgical technique has a good outcome in patients whose CTP and MELD scores predict a safe postoperative period.