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Concurrent Prolapsed Omphalocele and Giant Hepatic Cyst Initially Suspected as an Umbilical Cord Cyst in the Prenatal
Yuta Takeuchi1, Seiichiro Inoue1, Yuki Muta1
1Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Insights
This case report details an unusual co-occurrence of omphalocele and a congenital hepatic cyst, initially misdiagnosed as an umbilical cord cyst. Surgical intervention was necessary due to associated Beckwith-Wiedemann syndrome.
Area of Science:
- Medical Science
- Pediatric Surgery
- Fetal Medicine
Background:
- Umbilical cord cysts detected post-second trimester pregnancy are linked to complications like omphalocele.
- Congenital hepatic cysts are rare, and their coexistence with omphaloceles is exceptionally uncommon.
- This report addresses an unusual case of omphalocele with a large hepatic cyst, initially suspected as an umbilical cord cyst prenatally.
Introduction:
Umbilical cord cysts detected after the 2nd trimester of pregnancy are associated with a variety of complications, including omphalocele, and thus require careful monitoring. Congenital hepatic cysts are rare, as are reports of their coexistence with omphaloceles. Herein, we present an unusual case of an omphalocele complicated by a large hepatic cyst that was initially suspected to be an umbilical cord cyst during the fetal period.
Case Presentation:
A male infant was delivered via caesarean section at 36 weeks of age, with ruptured membranes and cloudy amniotic fluid. Fetal ultrasonography at 16 weeks had previously revealed an omphalocele with intestinal prolapse, and at 20 weeks, an umbilical cord cyst was suspected. At birth, the herniation sac ruptured, and abdominal wall closure and cyst excision were performed. The cyst, initially thought to be umbilical in origin, was instead identified as a hepatic cyst connected to the liver. Pathological examination confirmed the diagnosis. The infant was further diagnosed with Beckwith-Wiedemann syndrome, and was ultimately discharged 32 days postoperatively, with no recurrence to date.
Conclusions:
Although asymptomatic congenital liver cysts can often be managed conservatively with follow-up, we considered surgical intervention necessary in this case due to the presence of an omphalocele associated with suspected Beckwith-Wiedemann syndrome.
