# Hernia of the umbilical cord associated with type IIIa ileal atresia: A case report

## TL;DR

A rare case of umbilical cord hernia combined with type IIIa ileal atresia in a newborn highlights the need for early diagnosis and surgical care.

## Contribution

This case report documents the rare coexistence of umbilical cord hernia and type IIIa ileal atresia, emphasizing the importance of prompt surgical intervention.

## Key findings

- Umbilical cord hernia and type IIIa ileal atresia can coexist in neonates.
- Early surgical exploration is critical for infants with umbilical cord hernia and intestinal obstruction.
- Prenatal imaging, including ultrasound and fetal MRI, is essential for diagnosing such rare conditions.

## Abstract

Hernia of the umbilical cord and ileal atresia are rare congenital anomalies, each with distinct pathophysiology. The concurrence of these conditions is rarely reported and poses diagnostic and surgical challenges. This highlights the necessity for increased prenatal vigilance and may inform enhanced surgical planning in analogous situations.

We report the case of a 12-hour-old female neonate born with an umbilical protrusion containing bowel loops and exhibiting signs of intestinal obstruction. Prompt surgical intervention was performed. Surgical exploration revealed type IIIa ileal atresia, and the umbilical defect was classified as a hernia of the umbilical cord.

Hernia of the umbilical cord occurs when the umbilical ring fails to close during embryological development, allowing a bowel segment to herniate into the cord. Type IIIa ileal atresia is a severe form of intestinal atresia caused by an in utero vascular accident. Both conditions may coexist, with few reported cases. This necessitates early diagnosis and surgical management.

This case highlights the significance of comprehensive prenatal imaging for suspected umbilical malformations, the necessity of immediate surgical assessment for obstructed bowel, and the relevance of recognizing uncommon yet dangerous concomitant gastrointestinal defects.

•Awareness of the rare yet possible coexistence of type IIIa ileal atresia with an umbilical cord hernia is crucial.•Prompt intervention is necessary to address the diagnostic, surgical, and postoperative challenges in such infants.•Our case shows the necessity of early surgical exploration in neonates with umbilical cord hernia and intestinal blockage.•Prenatal ultrasound reveals a hyperechogenic bowel segment, requiring fetal MRI and lower gastrointestinal contrast study.

Awareness of the rare yet possible coexistence of type IIIa ileal atresia with an umbilical cord hernia is crucial.

Prompt intervention is necessary to address the diagnostic, surgical, and postoperative challenges in such infants.

Our case shows the necessity of early surgical exploration in neonates with umbilical cord hernia and intestinal blockage.

Prenatal ultrasound reveals a hyperechogenic bowel segment, requiring fetal MRI and lower gastrointestinal contrast study.