Flood syndrome managed by partial splenic embolization and percutaneous peritoneal drainage

Fumio Chikamori, MD; Kai Mizobuchi; Koji Ueta, MD; Haruka Takasugi; Sawaka Yukishige; Hisashi Matsuoka, MD; Norihiro Hokimoto, MD; Hiromichi Yamai, MD; Kazuhisa Onishi, MD; Nobuyuki Tanida, MD; Nobumasa Hamaguchi; Satoshi Ito, MD; Niranjan Sharma, MD

Radiology Case Reports (Jan 2021)

Flood syndrome managed by partial splenic embolization and percutaneous peritoneal drainage

Fumio Chikamori, MD,
Kai Mizobuchi,
Koji Ueta, MD,
Haruka Takasugi,
Sawaka Yukishige,
Hisashi Matsuoka, MD,
Norihiro Hokimoto, MD,
Hiromichi Yamai, MD,
Kazuhisa Onishi, MD,
Nobuyuki Tanida, MD,
Nobumasa Hamaguchi,
Satoshi Ito, MD,
Niranjan Sharma, MD

Affiliations

Fumio Chikamori, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan; Corresponding author.
Kai Mizobuchi: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Koji Ueta, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Haruka Takasugi: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Sawaka Yukishige: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Hisashi Matsuoka, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Norihiro Hokimoto, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Hiromichi Yamai, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Kazuhisa Onishi, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Nobuyuki Tanida, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Nobumasa Hamaguchi: Department of Surgery, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi, 780-8562 Japan
Satoshi Ito, MD: Department of Radiology, Japanese Red Cross Kochi Hospital, Kochi, Japan
Niranjan Sharma, MD: Te Kaika Caversham, Caversham, Dunedin, New Zealand

Journal volume & issue: Vol. 16, no. 1
pp. 108 – 112

Abstract

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Flood syndrome is a rare complication of cirrhosis of liver accompanied by ascites and a sudden rupture of umbilical hernia causing drainage of ascitic fluid from abdominal cavity. We report management of a case of Flood syndrome which was caused by rupture of incisional hernia. The clinical picture was similar to well described and widely accepted Flood syndrome. A 70-year-old female with decompensated hepatitis C cirrhosis was transported to the emergency department with a sudden drainage of ascitic fluid after sudden dehiscence of pre-existing incisional hernia and diffuse abdominal tenderness. Initially, she was managed by applying ostomy bag and diuretics to reduce the ascites. On 8th day of admission, a 16 Fr. drain was percutaneously placed in the left lower abdominal quadrant to divert the fluid from the abdominal wall defect. On 13th day, 80% partial splenic embolization (PSE) was attempted to control portal hypertension to reduce the ascites volume. After PSE, the hepatic venous pressure gradient reduced from 28 to 21cm H2O. The peritoneal drain was removed on 16th day and she was discharged on 22nd day. We conclude that PSE and temporary percutaneous peritoneal drainage are useful option to manage Flood syndrome.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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