# Hybrid Extended Totally Extraperitoneal Transversus Abdominis Release for Ruptured Incisional Hernia Etiologically Very Similar to Flood Syndrome: A Case Report

## TL;DR

A case report describes the successful surgical repair of a ruptured incisional hernia in a patient with liver cirrhosis, similar to Flood syndrome.

## Contribution

A novel surgical approach combining hybrid herniorrhaphy and eTEP-TAR is presented for treating ruptured incisional hernias in cirrhotic patients.

## Key findings

- The patient was successfully treated with hybrid herniorrhaphy and eTEP-TAR after preoperative management.
- The patient remained recurrence-free for 2 years post-surgery.
- Preoperative care and surgical strategy are critical for managing ruptured hernias in cirrhotic patients.

## Abstract

The rupture of an umbilical hernia, which is known as Flood syndrome, is a rare and life-threatening complication of liver cirrhosis. Herein, we report the successful repair of a ruptured incisional hernia accompanied by liver cirrhosis.

A female in her 40s with a history of alcoholic cirrhosis and ruptured acute umbilical hernia treated by primary closure 6 months earlier presented with ascites leakage from abdominal skin. She was diagnosed with a ruptured incisional hernia accompanied by massive ascites. We started preoperative management with topical corticosteroids and oral diuretics. Nine months after the first visit, hybrid herniorrhaphy, extended totally extraperitoneal transversus abdominis release (eTEP-TAR) was performed. The patient has since been well without any sign of recurrence for 2 years.

We experienced a successful treatment of a ruptured incisional hernia accompanied by liver cirrhosis. Preoperative management and surgical strategies are important for the treatment of ruptured incisional hernia and Flood syndrome.