Case 253: Thrombosed Umbilical Venous Varix in an Infant

Abstract

History A 3-month-old previously healthy girl presented to an outside institution with a 4-day history of low-grade fever, irritability, and a tender "knot" in the upper abdomen. Ultrasonography (US) was performed at an outside hospital. US images were not available for review; however, they showed a mass in the left hepatic lobe, per the outside report, and the patient was referred to our institution for further evaluation. Her parents reported a normal full-term pregnancy, with regular prenatal care and normal prenatal US findings. The baby was born after an uncomplicated gestation. She was delivered at term via an uncomplicated cesarean section due to a maternal history of cesarean section. The perinatal course was uncomplicated, and there was no history of umbilical catheterization, per the parents. On arrival at our institution, the patient had a temperature of 38.2°C. All other vital signs were normal. Palpation revealed a tender and firm mass in the periumbilical region; otherwise, physical examination findings were normal. Results of laboratory work-up were normal, except for elevated white blood cell count (26 600/mm [26.6 × 10/L]; normal, 6000-17 500/mm [6-17.5 × 10/L]). The patient underwent US followed by intravenous contrast material-enhanced (10 mL ioversol, Optiray 320; Medtronic, Santa Rosa, Calif) computed tomography (CT) on the same day.

Partial molar pregnancy with a normal live fetus and umbilical cord abnormalities: A novel association with long‐term follow‐up: A case report

“… 8 , 9 Cord varices are often diagnosed between 22 and 33 weeks of pregnancy in women with usually normal previous sonographic examination. 10 Some believe that these anomalies are developmental rather than congenital due to increased intraluminal pressure. 10 …”

“… 10 Some believe that these anomalies are developmental rather than congenital due to increased intraluminal pressure. 10 …”

“…It is known that umbilical cord anomalies comprise 4% of all fetal malformations, and the prevalence of umbilical vein varix is estimated at 0.4-1.1 in 1000; extra-abdominal varices are even rarer than the intra-abdominal ones. 8,9 Cord varices are often diagnosed between 22 and 33 weeks of pregnancy in women with usually normal previous sonographic examination. 10 Some believe that these anomalies are developmental rather than congenital due to increased intraluminal pressure.…”

Fetal death caused by embolization of ductus venosus resulting from detachment of umbilical vein thrombus

“…The presumed cause of this sudden intrauterine fetal death was complete obstruction of the ductus venosus pathway, confirmed by histological examination. Only two other cases with thrombosis in both the umbilical vein and the portal vein have been reported in the literature, but those were diagnosed after birth by ultrasonography and computed tomography, and there was no histopathological evidence of thrombosis in the portal vein 1,2 .…”