Intra-Abdominal Umbilical Vein Varix With Postnatal Portal Vein Thrombosis: A Case Report.
Xiaoyi Gong, Wei Feng, Yan Hua et al.
✦ AI-curated · Sources linked
Case in brief
A fetus of a 23-year-old primiparous woman was found to have an intra-abdominal umbilical vein varix at 24 + 2 weeks of gestation, with turbulent flow. Serial ultrasound showed progressive enlargement and persistent abnormal flow. After cesarean delivery, abdominal ultrasound on postnatal day 3 identified thrombosis of the portal vein and ductus venosus. Laboratory findings suggested transient hypercoagulability alongside infection and metabolic acidosis. The infant received anticoagulation and supportive care; although the thrombi had not obviously resolved in the short term, the infant improved clinically and was discharged on postnatal day 9.
What made this case unusual
The prenatal umbilical vein varix was followed by postnatal thrombosis involving both the portal vein and ductus venosus, with concurrent findings suggesting transient hypercoagulability.
Diagnostic / clinical pearl
When a fetal umbilical vein varix is detected, serial prenatal imaging and early postnatal assessment can identify persistent flow abnormalities and associated portal venous thrombosis.