Schaefer Inga-Marie, Männer Jörg, Faber Renaldo, Loertzer Hagen, Füzesi László, Seeliger Stephan
Department of Gastroenteropathology, University Medicine Göttingen, Robert-Koch-Straße 40, Göttingen, Germany.
Pediatr Dev Pathol. 2010 Sep-Oct;13(5):404-7. doi: 10.2350/09-10-0731-CR.1. Epub 2010 Jan 19.
A giant umbilical cord is a rare finding in mature newborns and originates from different developmental etiologies. We report on a case of a mature female newborn presenting a 50 × 8-cm giant umbilical cord without further malformations. Antenatal sonographic findings of a diffuse giant umbilical cord, elevated creatinine levels of 1.3 mg/dL in umbilical cord edema, gross and histopathological findings of allantoic remnants, and umbilical urinary discharge lead to the diagnosis of a patent urachus with retrograde micturition into the umbilical cord. Postnatal surgical repair was required. In antenatal sonography, cystic and diffuse changes should be considered in the differential diagnosis of a giant umbilical cord. In cases of diffuse enlargement, elevated umbilical creatinine can support the diagnosis of a patent urachus with open leakage into the Wharton's jelly. Appropriate surgical management is required.
巨大脐带在成熟新生儿中是一种罕见的发现，其起源于不同的发育病因。我们报告一例成熟女性新生儿，其脐带长50×8厘米且无其他畸形。产前超声检查发现脐带弥漫性增粗，脐带水肿时肌酐水平升高至1.3mg/dL，大体及组织病理学检查发现尿囊残余，以及脐带泌尿，这些表现提示诊断为脐尿管未闭且尿液逆行排入脐带。出生后需要进行手术修复。在产前超声检查中，巨大脐带的鉴别诊断应考虑囊性和弥漫性改变。在弥漫性增粗的情况下，脐带肌酐水平升高可支持脐尿管未闭且向华通胶开放渗漏的诊断。需要进行适当的手术处理。
