Umbilical Cord Hernia Incaserated – Neglected Case

Pediatric Surgery Departement, Medical Faculty of Andalas University

M. Djamil International Hospital, Padang

Efendi, Jon. Pediatric surgery M. Djamil International Hospital1

Arnofyan, B Pratama. Pediatric surgery M. Djamil International Hospital 2

Laroza, Fernando. Resident General Surgery M. Djamil International Hospital 3

Abstract

Introduction

Umbilical Cord Hernia is generally small and occurs at the umbilicus, with the umbilicus
extending from it. It is covered with a sac and often confused with omphalocele. The difference are
that it contains only midgut, never liver, and abdominal wall above the defect is normal. Few
associated anomalies are reported , these patients have malrotation although it is not usually a couse of
intestinal obstruction. This defect is easily reduced by holding the sac upward and gently massanging
the bowel into the peritoneal cavity. The fascia can always be closed primarily and a cosmetic
umbilicoplasty is nearly always feasible.

Case Report

A female baby 26 days old, was dilevery by midwife and have no routine antenatal care,
consult from emergency room with protuberant intestinal on umbilical covered by sac. From
anamnesis and physical examination, this patient we diagnose with umbilical cord hernia inkaserated.
In this patient we do emergency operation, intraoperative we found sac of hernia and part of ileum in
the sac. We explored and found adhesive intestinal, then we do adhesiolisis. The ileum was viable, and
we found perforation in 3 site of ileum 20 cm from ileosaecal valve, we do resection of ileum and then
do ileostomy. The fascia we closed primarily and make umbilicoplasty

Conclusion:

Umbilical cord hernia is the emergency situation that have to do operation immideatly. The
risk of delay operation is make the umbilical hernia was incaserated, perforated and make it adhesive
intestinal. The prognosis of the patient with delay operation was poor. In this case, we should to
diagnose the patient properly and operation immideatly to have good result.

Key Words : Umbilical cord hernia, Incaserated, ileostomy, umbilicoplasty.