Integrative Preoperative Optimization in Decompensated Cirrhosis: An Evidence-Based Case Report & Clinical Review
1*Nikhil Girase and 2Parikshit Shirode
1,2Department of Shalya Tantra, Parul University, Parul Institute of Ayurveda, Limda, Vadodara - 391760 (India) *Corresponding Author: Dr. Nikhil Girase Email: dr.nikhilgirase06@gmail.com
ABSTRACT
Cirrhosis complicated by portal hypertension and ascites significantly elevates morbidity and mortality during elective abdominal wall hernia repair. Managing secondary abdominal wall defects requires pre-procedural resolution of fluid accumulation. A 55-year-old male presented with a 1-year history of periumbilical swelling and discomfort. Imaging confirmed hepatic cirrhosis, portal hypertension, mild ascites, and a 4.3 mm reducible umbilical hernia. He was treated with a 1-year structured Ayurvedic protocol (including Picrorhiza kurroa, Phyllanthus niruri/urinaria, and compound metabolic formulations) targeting cellular hepatoprotection, diuresis (Mutrala), and purgation (Pitta Virechana).