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The report of a patient with cirrhosis, ascites and spontaneous perforation of an umbilical hernia is presented. Peritonitis developed and the hernia was repaired on the third day after perforation. The patient promptly improved and was discharged twenty-one days later. A review of the previously reported cases indicates that survival without repair is unlikely. We believe that any patient with cirrhosis and ascites and perforation of an umbilical hernia should have prompt repair of the hernia under local anesthesia with minimal disturbance of regional venous channels and tight enough closure to prevent leaking of ascitic fluid even in the presence of peritonitis.
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© 1963 Published by Elsevier Inc.