I am at stage 4 liver disease and have an umbilical hernia which has not caused much trouble but has gotten big and is now oozing a little blood. My primary doctor says it is too dangerous to operate because my platelets count is onlyv30
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hernia
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3 UpVoted this answer
i agree with this synopsis. But this is a dangerous situation either way. stage IV liver disease does make surgery very difficult but it also means you can bleed very easily just from bumping your liver.
When you liver doesnt work you blood doesnt have the ability to clot and bleeding from any trauma can be harmful to your health. you must take great precaution in all situations.
When you liver doesnt work you blood doesnt have the ability to clot and bleeding from any trauma can be harmful to your health. you must take great precaution in all situations.
2 UpVoted this answer
You have a dangerous problem. If it is getting larger, as is usually the case, and oozing it should be fixed before it gets worse and becomes an emergency. It is not without risk but repairing it emergently is associated with greater risk
1 UpVoted this answer
I have encountered this exact scenario several times and results of surgery have been excellent. There is no doubt that this problem will become worse because of your ascites. As this occurs, life threatening emergencies can develop and treatment becomes more difficult. It is true that risks of surgery exist, but there is no risk-free option in your case. The risks of surgery can be managed (ascites control with TIPS, platelet transfusion, excision of unhealthy/non-viable skin, etc) with excellent outcomes.
A healthy respect of the surgical risk is reasonable, but extreme pessimism is not warranted. Most liver failure patients tolerate surgery just fine. The consequences of hernia rupture (fluid loss leading to hepato-renal syndrome, peritonitis, etc) may be your biggest risk of death in the near future.
A healthy respect of the surgical risk is reasonable, but extreme pessimism is not warranted. Most liver failure patients tolerate surgery just fine. The consequences of hernia rupture (fluid loss leading to hepato-renal syndrome, peritonitis, etc) may be your biggest risk of death in the near future.
1 UpVoted this answer
I do not know on what basis is you liver disease but I believe you have to have fluid (ascites) in your abdomen. This is the reason it gotten big and also to have discharge from the area. I concur with your doctor that as long as your hernia is not incarcerated/strangulated, possibly I would not do elective surgery as this can complicate your situation. Have you considered a truss to hold the hernia in, it would be possibly less symptomatic. If you however would insist doing something surgically I would consider a second opinion from someone who has not seen examined you ever. Sometimes a fresh eye could do miracles too! Best of luck to you!!!
Success of hernia repair surgery is dependent on minimizing tension. Wound healing in general depends on adequate nutritional status. With stage 4 liver disease, and a swollen abdomen, repairing the hernia would not be a small undertaking, and would be at high risk for failure, regardless of the method of repair chosen.
Hernia surgery is out of the question until you are medically cleared for surgery. With platelets so low a surgeon can't control bleeding since clot formation is severely comprised. You may want to have a platelet transfer to stop the oozing.It is too dangerous now to consider elective surgery. With the aid of your MD, see if you can get yourself in shape for this procedure at a later time
Not knowing the cause of your liver failure (cancer, cirrhosis fro other causes, etc), it does seem that you have developed ascites. The ascites, and the inability to produce adequate platelets, means that your liver is not making the proteins that the body needs to 1) heal wounds and 2) stop bleeding. If your body has a hard time healing wounds and stopping bleeding, surgery is difficult and fraught with complications. You want to get this evaluated at a Liver Transplant Center if possible (first choice), otherwise a major medical center with liver specialists (hepatologist) or liver surgeons. Also, if you are a candidate for possible liver transplant (which can be determined by a Transplant Center), then you should also seek their opinion on whether repair of this should be held off until you have transplant surgery (i.e., at the same time).
Hi
Very difficult situation indeed. Yes, it is extremely dangerous to perform your hernia repair operation due to low platelets and stage 4 liver disease, however this is the exact situation when this operation must be done to avoid life threatening infection.
I strongly recommend going to specialized liver surgeon/center to get your hernia evaluate. These surgeons/centers have expertise in performing operations in precarious but necessary situations as yours.
Very difficult situation indeed. Yes, it is extremely dangerous to perform your hernia repair operation due to low platelets and stage 4 liver disease, however this is the exact situation when this operation must be done to avoid life threatening infection.
I strongly recommend going to specialized liver surgeon/center to get your hernia evaluate. These surgeons/centers have expertise in performing operations in precarious but necessary situations as yours.
It is dangerous, your playlets are low and because your liver does not work properly you stand a great change of bleeding. It is likely your have ascites (fluid in the abdomen ) this will increase your chance of re occurrence of the hernia no matter how it is repaired.
You could get an infection and your body is not properly nourished due to the liver failure and it would be difficult to fight off, the mesh if used may need to be removed.
The fluid in your abdomen could become infected again very difficult to treat could require many surgeries and ling term antibiotics.
You could get an infection and your body is not properly nourished due to the liver failure and it would be difficult to fight off, the mesh if used may need to be removed.
The fluid in your abdomen could become infected again very difficult to treat could require many surgeries and ling term antibiotics.
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