Congenital Hernia of the Umbilical Cord: A Case Report of Prenatal Ultrasound Diagnosis and Postnatal Clinical Correlation

Congenital hernia of the umbilical cord (CHUC) is an uncommon ventral abdominal wall defect often confused with a small omphalocele. This paper highlights the importance of recognizing the characteristic ultrasonographic appearance and the clinical criteria for definitive diagnosis. A 28-year-old woman undergoing routine 3rd trimester ultrasound at 34 weeks' gestation found a 6.69 cm × 7.72 cm lesion in the base of umbilical cord containing an intestinal loop, without any abnormal blood flow to adjacent cord vessels via color Doppler examination. The post-natal clinical image showed a similar umbilical lesion with presence of circular skin fold – "collar sign". surgical repair was uneventful. This case report shows the importance of prenatal ultrasonography in making the correct diagnosis of CHUC in order to prevent unnecessary injury to the bowel during delivery through appropriate cord clamping technique. The postnatal "collar sign" is a strong indicator, but confirmation is still needed intra-operatively.