The giant umbilical cord (GUC) is rare and may be an indication of an occult urachal remnant.
Features of the giant umbilical cord:
(1) diffuse enlargement of the umbilical cord
(2) increased diameter in the second or third trimester (Wildhaber et al used >= 3 cm, Young et al > 5 cm)
Differential diagnosis:
(1) patent urachal remnant
(2) pseudo-cyst (degeneration of Wharton's jelly)
(3) omphalo-mesenteric duct cyst
(4) vascular anomaly
(5) extrophy of the urinary bladder
If a connection between the umbilical cord and the urinary bladder is evident then the urachal remnant should be resected. If a connection is not detected then the infant should be monitored for clinical evidence of a patent uraches, including leakage of urine from the umbilicus or persistent urachal inflammation.
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