giant abdominal wall hernia in a patient with cryptogenic cirrhosis

abdominal wall hernias are common problems found in patients with cirrhosis because of persistently high intra-abdominal pressure. when abdominal hernias are neglected in such patients, they may become larger and could result in cosmetic problems and pressure effects that are also difficult to treat. we found a voluminous mass in the anterior abdominal wall of a 40-year-old patient with cirrhosis. the patient was operated on for acute cholecystitis 12 years earlier. abdominal computed tomography revealed an epigastric hernia presenting as a grossly distended hernia sac filled with serous fluid and intestinal loops. the patient was not operated on and was discharged with sodium-restricted diet and diuretics.