Umbilical Cord Case Series Hernia in Neonates: A Retrospective and Diagnostic Challenge

Abstract

Umbilical cord hernia (UCH) is an uncommon congenital defect that is frequently misdiagnosed as omphalocele minor, leading to underrecognition in clinical practice. In this retrospective case series, we reviewed seven neonates treated over four years at a tertiary paediatric surgical unit in Sri Lanka. All underwent surgical repair via an umbilical approach, with no recurrences noted during follow-up. Meckel’s diverticulum was the most common sac content, and unusual findings included liver and appendix. Two patients experienced postoperative complications requiring intensive care and ileostomy formation. Most cases were isolated anomalies, though one neonate presented with a previously unreported association of tracheoesophageal fistula. Notably, none of the cases were identified antenatally, underscoring the value of prenatal detection to avoid potential visceral injury at birth. Our experience highlights the diverse presentations of UCH and the importance of distinguishing it from omphalocele for appropriate management and prognosis.