{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:57:56Z","timestamp":1783976276095,"version":"3.55.0"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background: The literature reports few instances of spontaneous bowel eviscerations through umbilical hernia sites. Spontaneous rupture of the hernia sac is a less common complication, primarily associated with persistent ascites or congenital wall defects. Materials and methods: A systematic review was conducted using the PubMed database\u2014the United States National Library of Medicine, with the search terms \u201cspontaneous bowel evisceration\u201d and \u201cumbilical hernia evisceration\u201d. However, several results were deemed unsuitable for this manuscript. From a total of 185 cases, this review was narrowed down to 9 usable reports. Non-English language cases, duplicates, and cases unrelated to the pathology, including pediatrics, malformations, herniation through other organs, and animal cases, were excluded. Conclusions: Spontaneous evisceration in a hernia is an uncommon yet serious condition. A major risk factor appears to be underlying liver disease with its complications, such as ascites, chronic malnutrition with hypoalbuminemia, and collateral circulation formation. These factors contribute to the susceptibility of the sac and the hernia wall to rupture. However, the limited number of reported cases precludes the establishment of a preferred treatment approach. In the acute phase, the use of prosthetics may be less advisable, but in an elective setting, the cirrhotic patient could be offered repair.<\/jats:p>","DOI":"10.3390\/clinpract15060099","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T04:49:52Z","timestamp":1748234992000},"page":"99","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous Bowel Evisceration Through Umbilical Hernia Sites in Adult Patients: A Systematic Review of the Literature"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-1709","authenticated-orcid":false,"given":"Simone","family":"Gianazza","sequence":"first","affiliation":[{"name":"Department of General Surgery, Ospedale L Galmarini Tradate\u2014ASST Settelaghi, Piazza Zanaboni 1, 20149 Tradate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Grappolini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9968-8543","authenticated-orcid":false,"given":"Marika","family":"Morabito","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Palillo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5143-9767","authenticated-orcid":false,"given":"Marta","family":"Ripamonti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Inversini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1016\/S0140-6736(03)14746-0","article-title":"Hernias: Inguinal e incisional","volume":"362","author":"Kingsnorth","year":"2003","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"bcr1120103486","DOI":"10.1136\/bcr.11.2010.3486","article-title":"Spontaneous rupture of incisional hernia: A rare cause of a life-threatening complication","volume":"2011","author":"Gupta","year":"2011","journal-title":"BMJ Case Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_4","unstructured":"Ashcraft, K.W. 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