Umbilical Cord Hernia Research Articles

EP10.12: Vanishing umbilical cord hernia in a normal‐weight fetus: a distinct presentation of Beckwith–Wiedemann syndrome

EP10.12: Vanishing umbilical cord hernia in a normal‐weight fetus: a distinct presentation of Beckwith–Wiedemann syndrome

Body stalk anomaly

A 29-year-old pregnant woman was referred to our hospital at the gestational age of 15 weeks. The umbilical cord hernia was pointed out during a fetal echocardiogram at the previous obstetrician’s office, and the patient was referred to our obstetrician

A case of umbilical cord hemorrhagic ulceration with congenital upper gastrointestinal atresia

A 23-year-old woman (gravida 3, para 2) was referred to our hospital at 29 weeks of gestation by a nearby doctor due to hydramnios and suspected umbilical cord hernia. Ultrasound and magnetic resonance imaging indicated hydramnios, umbilical cord hernia, and a dilated stomach, with suspicion of upper gastrointestinal atresia. She was hospitalized at 33 weeks of gestation owing to membrane rupture. Fetal bradycardia was observed during delivery, and an emergency cesarean section was performed. A female infant weighing 1,799 g was delivered (Apgar score: 1/1); hemorrhagic ulceration of the umbilical cord was observed. Pancreatic phospholipase A2, trypsin, lipase, and bile acid levels in the amniotic fluid were elevated. The infant died of hemorrhagic shock and circulatory failure on the second day after birth. Based on these findings, we hypothesize that umbilical cord ulceration or hemorrhage may occur in congenital upper gastrointestinal atresia due to discharge of fetal gastrointestinal enzymes into the amniotic fluid.

Umbilical cord hernia with unusual content

Umbilical cord hernia with unusual content

Neonatal presentation of transected sigmoid colon following umbilical cord clamping: Hernia of umbilical cord

The umbilicus is a site of numerous embryopathies involving vessels, urachus, mid gut herniation, anterior abdominal wall defects and congenital cysts. Owing to lack of awareness, umbilical cord hernia (HUC) is often misdiagnosed and underreported, with limited data in the literature. We report an isolated case of congenital HUC and perinatal transection of the sigmoid colon during cord ligature by a midwife in a local health center. A six-day old female neonate presented with discharge of fecal matter through the umbilicus. The clamped cord, became swollen and auto-amputated on day of life three, after which fecal discharge was from the stump was noted. On examination a visible bowel loop containing stool was seen in the umbilical cord. We proceeded with surgical intervention via a small umbilical incision, with findings of transection of the sigmoid colon, no peritoneal contamination, and primary anastomosis was performed. There was event free recovery postoperatively. HUC is poorly understood and often misdiagnosed as omphalocele minor. One should be cognizant of HUC when noting swelling at the base of the cord so as to avoid any inadvertent iatrogenic enterotomy by close umbilical clamping.

Hernia of umbilical cord containing gallbladder

Journal of Neonatal Surgery is a peer-reviewed and open-access electronic journal. Only a few journals are being published on Neonatal Surgery especially from a developing country, which justifies the need of a new journal on this subject.

Congenital hernia of umbilical cord with patent vitellointestinal duct along with evisceration of gut\u2014a rare presentation and unusual management

BackgroundCongenital hernia of umbilical cord is a rare congenital anomaly. Due to its presentation as herniation of small bowel or other viscera into the umbilical cord, it is often misdiagnosed as omphalocele minor.Case presentationWe are reporting a rare case of congenital hernia of umbilical cord which presented with rupture of hernia sac and evisceration of small bowel loops with reverse ileal intussusception via a patent vitellointestinal duct. It was managed by first repositioning the gut with stoma at umbilical site as a temporizing measure followed by definitive surgery in the form of resection of patent vitellointestinal duct and end to end ileal anastomosis.ConclusionCongenital hernia of umbilical cord with patent vitellointestinal duct is a rare abdominal wall defect which can present beyond neonatal period with evisceration of gut. A high index of suspicion should be kept by the first attending clinician to avoid a delay in management.

Umbilical cord hernia with Meckel's diverticulum

Umbilical cord hernia is a rare and benign congenital defect of the abdominal wall, usually misdiagnosed as omphalocele. Its association with Meckel's diverticulum is very rare, with only few cases described in literature. We present a case of a male child that was prenatally diagnosed with a minor omphalocele at 16 weeks of pregnancy. Other malformations were excluded and genetic testing was normal. The pregnancy was otherwise uneventful and the baby was born at 39 weeks without complications. Postnatally, a bulge with air and fluid content was palpable at the base of the umbilical cord stump. The baby started refusing oral feeding at 12 hours of life and the abdominal radiography showed intestinal herniation, confirming an umbilical cord hernia. Surgical exploration showed a herniated Meckel's diverticulum, and a wedge diverticulectomy and umbilicoplasty were completed without complications. In this case, the high index of suspicion warranted an early involvement of the pediatric surgery team, which contributed to the correct diagnosis before manifestation of intestinal obstruction symptoms.

Incomplete pentalogy of Cantrell: a case report and review

BACKGROUND: The pentalogy of Cantrell is a rare congenital malformation characterized by five component defects in the anterior abdominal wall, lower sternum, anterior diaphragm, and diaphragmatic pericardium and congenital heart disease. The occurrence of the five features is quite rare. The pentalogy of Cantrell is classified as complete, partial, and incomplete. Few studies have described the successful treatment of neonates with the pentalogy of Cantrell, with even fewer publications about an incomplete defect.
 CASE REPORT: We report the successful surgical treatment of a newborn boy with an incomplete pentalogy of Cantrell. In this patient, the diaphragmatic hernia was eliminated at the first stage, and a temporary container for umbilical cord hernia was made by suturing the silastic sac to the edges of the defect in the anterior abdominal wall for subsequent gradual immersion of the hernia contents into the abdominal cavity. These steps made it possible to reduce intra-abdominal and, accordingly, intrathoracic pressures, provide favorable conditions for the healing of the diaphragm, and thus stabilize the childs respiratory and cardiovascular systems. Subsequently, the cardiovascular system was examined under more favorable conditions and intracardiac defects were excluded. Moreover, the proposed technique made it possible to safely perform the second stage of surgical correction, i.e., radical plasty of the anterior abdominal wall on day 14 of life with full restoration of the normal anatomical and physiological relationships, by which time the diaphragm and mediastinum had taken their correct topographic position. The literature review provides data from 32 sources.
 CONCLUSION: The pentalogy of Cantrell is a severe congenital malformation with a high risk of poor outcomes. Reporting of all possible variants of the pentalogy of Cantrell (complete, partial, or incomplete), regardless of the outcome, is important for the accumulation of experience in treating such patients, which by focusing on the clinical situation and the combination of various defects in the pentalogy of Cantrell will improve the strategy and prognosis for this defect.

Liver as sole content of umbilical cord hernia

Hernia of the Umbilical Cord (HUC) is a distinct form of ventral abdominal wall defects, commonly misinterpreted as Omphalocele minor. Usually, the contents are the small intestine, large intestine, or vitello-intestinal duct remnants; but rarely liver, gall bladder, or spleen may entrap into the sac. In this case series, we present three unusual cases of Hernia of the Umbilical Cord with the liver as the sole content. All three underwent surgical intervention and were managed successfully. To the best of our knowledge, there are only a few case reports of such presentations.

Iatrogenic intestinal perforation in umbilical cord hernia

Abstract We report a case of 1-day-old boy referred with suspicion of umbilical cord hernia, who had a broad based umbilical cord. Iatrogenic intestinal perforation due to clamping of an umbilical cord hernia which contained intestinal loop was noticed after the clamp unlocked. This complication resulted from failure to diagnose umbilical cord hernia and application of the cord clamp too close to the umbilical ring.

Liver as Main Content of Hernia of Umbilical Cord

Please see fulltext

Umbilical Cord Hernia Associated with a Patent Urachus: A Case Report

An umbilical cord hernia (UCH) is a form of abdominal wall defect, affecting 6 out of every 10,000 newborns. The persistence of urachus is an embryonic remnant that connects the bladder to the abdominal wall at the level of the umbilicus, being yet more uncommon. We reviewed the literature, searching in PubMed, under the terms “Hernia of umbilical cord”, “Congenital hernia of cord” and “Persistent Urachus”. Only a few similar cases of both pathologies associated described were found. Our main objective is to highlight the distinct clinical features, embryogenesis, prognosis and associated anomalies of two infrequent embryopathies. And to describe a infrequent case of both abnormalities presenting simultaneously. UCH are often misdiagnosed with other abdominal wall deffects, such as omphalocele, umbilical hernias, gastroschisis and umbilical cord cysts. The normal cord insertion, adequate muscle development of the abdominal wall and a wall defect less than 5cm is what differentiates it from an omphalocele. UCH has a low morbidity overall, as it is not associated with other anomalies. The most frequently observed urachal malformations are the persistence of a urachus and urachal cyst. The prenatal diagnosis of patent urachus is made by ultrasound or magnetic resonance, being easily mistaken with abdominal wall defects, confirming the diagnosis with an ultrasound at birth. The persistence of urachus may resolve spontaneously, if not, surgical resolution is recommended. Similar to a UCH, a patent urachus shows little association with other malformations. It is important to know the clinical presentation and the diagnostic perinatal methods employed for appropriate management and favorable results for both pathologies. This relies on knowing when to suspect possible associated anomalies and when complementary studies might be needed. It is also important to be aware that there is the possibility of a UCH and a patent urachus existing simultaneously.

In-utero, incarcerated umbilical hernia with fistula

Abstract Omphalocele, gastroschisis, and umbilical hernia are abdominal wall defects well-characterized by their clinical presentation, umbilical cord position, treatment options, and clinical course. Differentiating omphalocele from umbilical cord hernia can be challenging. To our knowledge this is the first case of an incarcerated umbilical hernia with a fistula that may have originated in-utero.

Hernia of the umbilical cord: a clinical spectrum

Background: Hernia of the umbilical cord is a rare clinical entity which presents with hernia of the small bowel into the proximal part of the umbilical cord. This is sporadically associated with other congenital malformations. This is usually poorly identified and mistakenly termed as ‘omphalocele minor. Inadvertent clamping of the cord in these cases leads to iatrogenic bowel wall injury. The aim of this study is to present a spectrum of cases presenting with umbilical cord hernia in a tertiary care Govt medical college, along with demography, intra operative findings, associated malformations and postoperative outcome and 1 year follow up.Methods: This is an ambispective study on neonates who attended the Outpatient Department (OPD) or Emergency department. The babies were evaluated by age, birth weight, gender, any gross clinical malformation. They were also evaluated intraoperatively for any associated anomalies. Post-surgery the babies were followed up until 2 years of age in pediatric surgery OPD of the same institute and outcome was recorded.Results: Out of 90 babies, 88 babies (97.77%) had body weight more than 2.5 kg, and rest 2(2.22%) had bodyweight of 1.5kg and 1.8 kg. Regarding content of contents of umbilical cord hernia, out of 87 patients, 43 patients (49.42%) had ileal loop as, 32 patients (36.78%) had ileum with Meckel’s diverticulum, 6 patients (6.39%) had cecum with appendix.Conclusions: Most of this study cases had ileal loops as content of the hernial sacs, and 36.78% cases had Meckel’s diverticulum associated, which is a remnant of Vitello intestinal duct. Prompt identification of the condition and early intervention and adequate post-natal care are affective to prevent long term morbidity.

Pattern of prenatal ultrasound diagnosed anterior abdominal wall defects at the University College Hospital, Ibadan, Nigeria: A pictorial essay

Anterior abdominal wall defects form a wide spectrum of congenital abnormalities that allow the abdominal contents to protrude through an unusual opening on the abdominal wall. These defects could be physiological or pathological depending on the time of diagnosis. They include physiological gut herniation, congenital umbilical cord hernia, omphalocele, gastroschisis, ectopia cordis, bladder exstrophy, body-stalk anomaly, Prune-Belly Syndrome, and pentalogy of Cantrell. Correct prenatal diagnosis of these anomalies with ultrasound (US) is extremely important for patient management. Evaluation of the defect relative to the umbilical cord insertion site is fundamentally important in differentiating among the various malformations. We present a pictorial essay of the spectrum of anterior abdominal wall defects diagnosed prenatally with US seen over a 5-year period at the University College Hospital, Ibadan.

Congenital Umbilical Appendix Misdiagnosed as Umbilical Granuloma: Report of 2 Cases

Background: Umbilical cord hernia is an uncommon umbilical anomaly which develops during 10th to 12th weeks of gestational age owing to failure of complete bowel return into coelomic cavity. In extremely rare cases appendix is the only trapped organ in hernia sac which may erode the overlying membrane and simulate umbili-cal granuloma.
 Case Report: Two infants presented with delayed umbilical cord separation with a reddish mass at umbilicus which was initially diagnosed as umbilical granuloma. Surgical exploration on failure of conservative measures revealed it as vermiform appendix. Appendectomy was done in both cases.
 Conclusion: Vermiform appendix at umbilicus is a rare congenital anomaly and may simulate other pathologies at umbilicus.

Fetal anterior abdominal wall defects: prenatal imaging by magnetic resonance imaging.

Abdominal wall defects range from the mild umbilical cord hernia to the highly complex limb-body wall syndrome. The most common defects are gastroschisis and omphalocele, and the rarer ones include the exstrophy complex, pentalogy of Cantrell and limb-body wall syndrome. Although all have a common feature of viscera herniation through a defect in the anterior body wall, their imaging features and, more important, postnatal management, differ widely. Correct diagnosis of each entity is imperative in order to achieve appropriate and accurate prenatal counseling and postnatal management. In this paper, we discuss fetal abdominal wall defects and present diagnostic pearls to aid with diagnosis.

Congenital hernia of the umbilical cord with patent vitello-intestinal duct in a newborn: A rare case

Congenital hernia of the umbilical cord is a less frequent entity in newborns and occasionally associated with other maladies. Sometimes, a large umbilical cord hernia is confused with small omphalocele. We report an unusual case of umbilical cord hernia associated with patent vitello-intestinal duct in a male newborn who underwent surgery and discharged with good general condition.

Umbilical Cord Hernia: Report of an Unusual Case

Congenital umbilical cord hernia is fairly common in infants and it is rarely associated with other anomalies. Sometimes, large umbilical cord hernia is confused with Small omphaloceles. We report an unusual case of umbilical cord hernia associated with patent vitello-intestinal duct (PVID), and Meckel's diverticulum underwent surgery and discharged with good general condition.