Management of incarcerated inguinal hernia in a patient with yellow nail syndrome

ABSTRACT
While abdominal wall hernias are often seen in cirrhotic patients, they have not been previously reported following chylous ascites secondary to yellow nail syndrome. In general, repairing abdominal wall hernias in patients with ascites are associated with significant morbidity, recurrence rate and mortality, and are therefore often managed expectantly. Hernial incarceration or strangulation in these patients is a life-threatening complication, and requires urgent surgical intervention. To highlight this difficult issue and its emergency management and repair, we present this report of a 46-year-old man, who was known to have yellow nail syndrome and who was hospitalised for incarcerated inguinal hernia, massive chylous ascites, severe lower limbs oedema, hypoproteinaemia, hypoalbuminaemia and hypocalcaemia.

Keywords: chylous ascites, emergency hernia  operation, incarcerated inguinal hernia, inguinal  hernia, yellow nail syndrome
Singapore Med J 2008; 49(2):155-7