Frontiers Journal of Case Reports and Images

RUPTURATERD CONGENITAL UMBILICAL CORD HERNIA (CHUC) IN NEWBORN OPERATIVELY TREATED 4 HOURS AFTER DELIVERING

Keywords : CHUC, Umbilical Hernia, Omphalocele

Abstract

Umbilicus is a site of numerous embryopathies involving vessels, urachus, midgut herniation, anterior abdominal wall defects and congenital cysts. Congenital hernia of the umbilical cord (CHUC) is a rare congenital midline (incidence 1:5000) abdominal defect as compared to the umbilical hernia which is much more common and occurs post-natally. Despite its recognition as a distinct entity since 1920s, CHUC is often misdiagnosed as a small omphalocele, resulting in its under-reporting. These masses may be easily overlooked at birth.

In this case, we will present new-born that had congenital hernia of the umbilical cord (CHUC) which was wrapped around its neck, shoulders and upper belly and it ruptured during delivery, exposing in this way small intestines to the external environment. Newborn was operated after admission in Clinical University Centre in Sarajevo (KCUS), four hours after birth. The operation was performed fast and well after quick preoperative preparation (enemas, nasogastric tube, administration of antibiotics and laboratory findings, belly ultrasound, X rays of pulmo and cor) and postoperative course was uneventful. This is rare case and can be easily be mistaken for ruptured omphalocele or even gastroschisis, but care must be taken in consideration during ligation of the umbilical cord not to clamp intestines that can be present in CHUC that did not rupture. After the rupture, operative treatment must be performed as soon as possible due to exteriorisation of the intestines to external environment..

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