Skip to main content
SpringerLink
Log in

Correlation of hernia with portal cirrhosis

A reevaluation of the role of ascites

  • Published:
The American Journal of Digestive Diseases Aims and scope Submit manuscript

Summary

1. A series of 66 consecutive male cirrhotic and 130 consecutive male noncirrhotic patients were studied with respect to the incidence of hernia, and a reevaluation was made of the role played by ascites.

2. Hernias occurred in 25 (38 per cent) of 66 cirrhotic patients, but in only 12 (9 per cent) of 130 noncirrhotic patients. This difference was statistically highly significant.

3. In the 25 cirrhotic patients with hernia, 11 (44 per cent) had no history of ascites, while at least 23 (92 per cent) had no ascites prior to the onset of hernia. In 12 cirrhotic patients with both hernia and ascites, the dates of onset of hernia and of ascites were studied. These subjects accounted for 15 hernias, 14 of which preceded ascites by 2 to 30 years. Only one hernia appeared to have developed simultaneously with the accumulation of the intra-abdominal fluid, but this was a recurrence of an old hernia. The data do not support the concept that ascites is the cause of hernia in patients with cirrhosis.

4. The implications of these observations are discussed. The suggestion is made that portal cirrhosis and hernia are the results of an inherent systemic mesenchymal defect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kirmisson, E. Cirrhose du foie s'étant manifestée pour la première fois à la suite d'une opération de hernie crurale etranglée; évolution rapide de la maladie; mort; autopsie.Gaz. hebd. de méd. Par. 20:753, 1883.

    Google Scholar 

  2. Blumenau, E. Ueber Todesursache bei Lebercirrhose.Arch. Verdaungskr. 27:1, 1920.

    Google Scholar 

  3. Chapman, C. B., Snell, A. M., andRowntree, L. G. Decompensated portal cirrhosis: Report of 112 cases.J.A.M.A. 97:237, 1931.

    Google Scholar 

  4. Chapman, C. B., Snell, A. M., andRowntree, L. G. Compensated cirrhosis of the liver; a plea for more intensive consideration of the earlier stage of disease of the hepatic parenchyma.J.A.M.A. 100:1735, 1933.

    Google Scholar 

  5. Mc Cartney, J. S. Latent portal cirrhosis of the liver.Arch. Path. 16:817, 1933.

    Google Scholar 

  6. Henrikson, E. C. Cirrhosis of the liver, with special reference to surgical aspects.Arch. Surg. 32:413, 1936.

    Google Scholar 

  7. Altschule, M. D. Hernias as presenting complaint in patients with cirrhosis and ascites.New England J. Med. 224:351, 1941.

    Google Scholar 

  8. Tanyol, H. Leberzirrhose als konstitutionelle Erkrankung. Read before the Wiener medizinische Gesellschaft, Vienna, Austria, April 17, 1944. (Wien. klin. Wchnschr. 57:208, 1944).

  9. Fagin, I. D., andThompson, F. M. Cirrhosis of the liver. An analysis of 71 cases.Ann. Int. Med. 21:285, 1944.

    Google Scholar 

  10. Patek, A. J., Jr.,et al. The dietary treatment of cirrhosis of the liver. Results in 124 patients observed during a ten-year period.J.A.M.A. 138:543, 1948.

    Google Scholar 

  11. Tanyol, H. Contribution a l'étude de la pathogénie de la cirrhose hepatique. Compt. rend. du 5e Congrès International de Pathologie Comparée. Istanbul, Turkey, 1949, p. 219.

  12. Tanyol, H. Cirrhosis of the liver as part of a systematic mesenchymal disorder. (Abstract) Program of the Fifty-fourth Annual Meeting of the American Gastroenterological Assoc., Atlantic City, N. J., 1953, p. 48.

  13. Scherf, M. Prognostische und diagnostische Irrtümer bei langsam verlaufender, kompensierter Leberzirrhose.Münch. med. Wchnschr. 96:1087, 1954.

    Google Scholar 

  14. Tanyol, H., andMenduke, H. Umbilical ptosis; frequent physical sign in portal cirrhosis.Am. J. Digest. Dis. NS 1:417, 1956.

    Google Scholar 

  15. Yonemoto, R. H., andDavidson, C. S. Herniorrhaphy in cirrhosis of the liver with ascites.New England J. Med. 255:733, 1956.

    Google Scholar 

  16. Watson, L. F. Hernia; Anatomy, Etiology, Symptoms, Diagnosis, Prognosis, and Treatment. (Ed. 3), St. Louis, Mosby, 1948, pp. 164, 306, 392, and 409.

    Google Scholar 

  17. Bauer, J. Constitution and Disease: Applied Constitutional Pathology. (Ed. 2), New York, Grune, 1945, p. 54.

    Google Scholar 

  18. Curtius, F. Untersuchung über das menschliche Venensystem; Septumvaricen und Oslersche Krankheit als Teilerscheinung Allgemeiner ererbten Venendysplasie (Status varicosus).Klin. Wchnschr. 7:2141, 1928.

    Google Scholar 

  19. Curtius, F. Untersuchungen über das menschliche Venensystem; die allgemeine, erebte Venenwanddysplasie (Status varicosus).Deutsche Arch. klin. Med. 162:330, 1928.

    Google Scholar 

  20. Steiger, R. Ergebnisse der Untersuchung einer grossen bernischen Sippe mit Teleangiectasia haemorrhagica hereditaria Osler.Schweiz. med. Wchnschr. 75:73, 1945.

    Google Scholar 

  21. Memmesheimer, A. M. Zur Pathogenese der sogenannten essentiellen Teleangiektasien.Dermat. Ztschr. 53:399, 1928.

    Google Scholar 

  22. Rosenthal, F., andUnna, P. Über das Wesen der Oslerschen Krankheit.Klin. Wchnschr. 12:856, 1933.

    Google Scholar 

  23. Neumark, S. Oslersche Krankheit.Zentralbl. Haut-u. Geschlechtskr. 56:383, 1937.

    Google Scholar 

  24. Urbach, E. Oslersche Erkrankung mit diffusen Schaedigung des Hautbindegewebes.Zentralbl. Haut-u. Geschlechtskr. 58:5, 1938.

    Google Scholar 

  25. Van Bogaert, L., andScherer, J. H. Hémangiomatose familiale de Rendu-Osler et cirrhose hépatique; contribution à l'étude des cirrhoses familiales.Ann. méd. 38:290, 1935.

    Google Scholar 

  26. Schuster, N. H. Familial haemorrhagic telangiectasia associated with multiple aneurysms of splenic artery.J. Path. & Bact. 44:29, 1937.

    Google Scholar 

  27. Williams, F. H., andSnell, A. M. Pulsating angioma (generalized telangiectasia) of the skin associated with hepatic disease.A.M.A. Arch. Int. Med. 62:872, 1938.

    Google Scholar 

  28. Johnson, S. R., andNordenson, N. G. Oslersche Krankheit (mit besonderer Berücksichtigung von Leberschaeden)—ein relativ unbeachtetes klinisches Smptom.Zentralbl. Haut-u. Geschlechtskr. 69:430, 1942.

    Google Scholar 

  29. Schüpbach, A. Teleangiektasiebildung und Leberkrankheiten (Morbus Osler und Leberzirrhose—Die eruptiven pulsierenden Sternnaevi bei Leberleiden).Schweiz. med. Wchnschr. 73:1186, 1943.

    Google Scholar 

Download references

Author information

Author notes

  1. H. Tanyol M.D.

    Present address: Department of Physiology, The Jefferson Medical College of Philadelphia, Philadelphia, Pa

Authors and Affiliations

  1. From the Department of Medicine, Division of Gastroenterology, The Jefferson Medical College of Philadelphia, Philadelphia, Pa

    H. Tanyol M.D.

Authors
  1. H. Tanyol M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

I wish to thank Drs. H. Tumen, John E. Deitrick, W. Paul Havens, Jr., M. Beiler, and I. Sher for their helpful comments and suggestions, and Dr. H. Menduke for the statistical analysis of the results.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tanyol, H. Correlation of hernia with portal cirrhosis. Digest Dis Sci 3, 444–453 (1958). https://doi.org/10.1007/BF02231260

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02231260

Keywords

Search

Navigation