Obstructed congenital hernia of umbilical cord in a Nigerian newborn and its diagnostic conundrum

Abstract

Background: 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.

Case Presentation: 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.

Conclusion: 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.