Gradually Enlarging in Surgery — 58yo Man | General Surgery | SMLE Q#19928

SMLE Question #19928

Surgery General Surgery

Objective: OBJ-076

Last updated: May 2026
A 58-year-old man with decompensated liver cirrhosis presents with a gradually enlarging, reducible umbilical bulge that becomes painful with coughing. He has tense ascites despite diuretics and required large-volume paracentesis twice in the last month. Examination shows abdominal distension with a fluid wave and a 3-cm reducible umbilical hernia without skin ulceration, obstruction, or strangulation. Elective repair is being considered. What is the most appropriate mesh-related management in this patient?

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