Flood Syndrome in a chronic Hepatitis patient

This is a case of an elderly women with chronic Hepatitis B and was not on treatment came to our centre with the complaints of abdominal distension,pain and leaking of ‘yellowish fluid’ from her umbilicus.She claimed that the leaking was recent after the detachment of her belly button.Otherwise, she also had nausea,vomiting,loss of appetite and jaundice.Blood profiles showed transaminitis with very low albumin level.On examination,her abdomen was very distended with the presence of ascites.The umbilicus was necrosed and detached from the surrounding skin.There were no signs of inflammation seen surrounding the umbilicus.This is a classical Flood Syndrome where the umbilicus give away due to pressure necrosis by the increasing ascitic fluids.We attached a stoma bag and referred the case to the medical team.The necrosed umbilicus was left as it is and the defect become a natural conduit for the flow of the ascitic fluids.