SPR Unknown #64-- FINAL

Fetal Imaging Committee


Publication Date: 2012-01-10

History

21 year old female with abnormality on screening prenatal ultrasound. MRI performed in follow up.

Findings

On the axial image, the liver is herniated out of the fetal abdomen at the midline. It is contained within a sac. In the sagittal plane, the umbilical cord appears to insert on the omphalocele sac at the junction of the sac and the herniated liver. The insertion site is better visualized on the coronal image where the cord can be seen inserting onto the omphalocele sac.

Diagnosis

Omphalocele containing liver

Discussion

An omphalocele occurs when there is herniation of the abdominal contents into the base of the umbilical cord. The abdominal contents are contained within a sac composed of the parietal peritoneum, amnion and Wharton’s jelly. The umbilical cord inserts on the sac rather than onto the abdominal wall. Omphaloceles are associated with many fetal anomalies.

A similar defect, gastroschisis, is a right-sided paraumbilical defect where bowel is eviscerated through an abdominal wall defect. The umbilical cord inserts on the abdominal wall, to the left of the defect. Furthermore, there should not be a sac surrounding the herniated contents, and generally, it only contains small and large bowel loops. Gastroschisis is not usually associated with other anomalies.

Files

3 images