Hernia and abdominal wall: umbilical hernia with ascites: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hernia and abdominal wall: umbilical hernia with ascites

Sample item

A cirrhotic patient with tense ascites has a symptomatic, reducible swelling at the umbilicus with thin shiny skin over it, but no leak or tenderness. How should it be managed?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Control the ascites medically, then repair

Raised intra-abdominal pressure from ascites predisposes to recurrence, skin necrosis and leakage after repair. Elective repair is done after medical control of the ascites with diuretics and paracentesis. Urgent repair is reserved for ulceration, leak or strangulation.

Option by option

  • A. Insert a peritoneovenous shunt for the hernia

    A shunt is not a standard treatment for the hernia and carries its own major complications.

  • B. Repair immediately without any preparation

    Repair on tense ascites carries a high risk of recurrence, wound leak and infection.

  • C. Control the ascites medically, then repair (correct)

    Correct. Optimising ascites before elective repair lowers recurrence and wound leakage.

  • D. Apply a truss and never operate

    A truss is poorly tolerated and does not prevent complications of thin skin or rupture in the long term.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Control the ascites medically, then repair. Raised intra-abdominal pressure from ascites predisposes to recurrence, skin necrosis and leakage after repair.

Why is "Insert a peritoneovenous shunt for the hernia" not the answer?

A shunt is not a standard treatment for the hernia and carries its own major complications.

Why is "Repair immediately without any preparation" not the answer?

Repair on tense ascites carries a high risk of recurrence, wound leak and infection.

Why is "Apply a truss and never operate" not the answer?

A truss is poorly tolerated and does not prevent complications of thin skin or rupture in the long term.

What concept does this question test?

It tests Hernia and abdominal wall: umbilical hernia with ascites in General Surgery. Elective repair is done after medical control of the ascites with diuretics and paracentesis. Urgent repair is reserved for ulceration, leak or strangulation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia and abdominal wall: umbilical hernia with ascites?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.