Congenital hernia of umbilical cord masquerading as umbilical cyst and omphalocele on antenatal scans

Congenital hernia of the umbilical cord (CHUC) is a rare, distinctive anomaly with variable presentation and conflicting terminology. We report two newborn infants who had fetal antenatal diagnosis as umbilical cord cyst and omphalocele, respectively, and were subsequently found to have hernia into the umbilical cord. The herniating mass in CHUC may vary greatly in size, making it difficult to differentiate with other conditions such as congenital umbilical cord cyst, cord hematoma, omphalocele, and gastroschisis. CHUC is prone to inadvertent cord clamping and injury to the gut. The failure of retraction of intestinal loops following physiological herniation has been postulated as the embryological basis of this entity. Overall prognosis is good.