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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