Ishola A A, Egbuchulem K I, Olulana D I
Division of General Surgery, Department of Surgery, University College Hospital, Ibadan.
Division of Paediatric Surgery, Department of Surgery, University College Hospital, Ibadan.
Ann Ib Postgrad Med. 2023 Dec;21(3):75-78. Epub 2024 Jan 30.
Congenital Hernia of umbilical cord (CHUC) is a rare presentation. The failure of return of intestinal loops following physiological herniation has been postulated as the embryological basis of this condition. This is usually mistakenly termed as omphalocele minor. We aim to highlight this rare finding, the clinical features, diagnostic dilemma, and management of CHUC.
He is a 4-day old male with obstructed CHUC. He had an oedematous umbilical stump, with circumferential normal abdominal wall skin folds in the form of a collar wrapping round the proximal aspect of the protrusion. The umbilical defect measured about 4 cm in diameter. Subsequently, surgical reduction and repair of defect was done, with resolution of symptoms.
CHUC though a rare entity and easily missed, accurate diagnosis and management offer good prognosis. Also, recognition will prevent iatrogenic bowel injury from careless clamping of the cord with associated morbidity and mortality. It also helps to prevent mis categorization and prevent unwarranted anxiety with misdiagnosis.
先天性脐带疝(CHUC)是一种罕见的病症。生理疝形成后肠袢未能回纳被假定为该病症的胚胎学基础。这通常被错误地称为小型脐膨出。我们旨在强调这一罕见发现、CHUC的临床特征、诊断困境及治疗方法。
他是一名4天大的患有梗阻性CHUC的男婴。其脐带残端水肿,在突出物近端周围有呈项圈状的正常腹壁皮肤褶皱环绕。脐部缺损直径约4厘米。随后进行了手术复位及缺损修复,症状得以缓解。
CHUC虽是罕见病症且易被漏诊,但准确的诊断和治疗可带来良好预后。此外,认识到这一点可防止因不小心钳夹脐带而导致医源性肠损伤及其相关的发病率和死亡率。这也有助于防止错误分类,并避免因误诊而产生不必要的焦虑。