Caudate lobe of the liver as the only content of the umbilical cord hernia

OpenAlex İngilizce

Umbilical cord hernia (UCH) is the least common of abdominal wall defects, wherein there exists an amniotic sac only containing intestinal loops protruding through a defect with a diameter less than 4 cm (Klein 2012). A 2600 gram female newborn was referred. Her physical examination revealed an umbilical cord hernia with a diameter of 3.5 cm. There was no associated anomaly. Bowel ischemia was suspected because of purple color and urgent surgical repair was planned (Fig. 1a). When the sac was opened, there was no bowel in it. Instead, caudate lobe of the liver was the only content of the sac (Fig. 1b). The liver was dissected free from the sac and repositioned into the abdomen. She fed orally on postoperative second day, and was discharged on the sixth day uneventfully. (a) The purple color appearance of the umbilical cord hernia and the operation scene. (b) The partially freed sac and the caudate lobe of the liver in the sac. The well-known facts about UCH are that it is the least common of abdominal wall defects, its diameter is less than 4 cm, a membrane covers it, the only content is midgut, and it is able to be repaired primarily (Haas et al. 2011; Klein 2012). When bowel ischemia is suspected because of dark purple color of the sac, the management should be done immediately. We did so in the present case; however, we were faced with an unusual content – "caudate lobe of the liver". There are very few reports revealing liver content of UCH in the literature. It has been reported that the accessory lobe of the liver or gallbladder has been in the sac (Festen et al. 1988; Elmasalme et al. 1995). Nearly the whole liver appearing in the UCH has also been reported very rarely (Zameer et al. 2012). The present case is the first report of UCH including only the caudate lobe of the liver besides these cases. This unusual and rare content should be kept in mind in cases with umbilical cord hernia that is dark in color to avoid causing fatal liver damage. None declared.