Abdominal hernia developing as a complication of cirrhosis of the liver with ascites is a welldocumented entity.1 We recently encountered a patient with such a complication, who spontaneously perforated an umbilical hernia, resulting in a natural paracentesis. To the best of our knowledge this phenomenon has not previously been reported.
Report of a Case
The first Meadowbrook Hospital admission of this 47-year-old man, in January, 1956, was because of the development of ascites. He had a history of "moderate" alcoholic intake for many years. Pertinent physical findings at that time were a loss of chest hair, hemangiomas over the neck and scapulae areas, and extensive psoriasis. His abdomen was distended with fluid, and the liver edge was felt 3 in. below the right costal margin. The spleen was not felt. Studies of liver function revealed an indirect bilirubin level of 5.0 mg.%, cephalin flocculation 4+, alkaline phosphatase level 21