Umbilical vein varix

Heron Werner, MD.

Clínica de Diagnóstico por Imagem – CDPI, Rio de Janeiro - Brazil.

Definition

Umbilical vein varix is a rare entity better visualized by color Doppler, power Doppler and pulsed wave Doppler. Typical appearance of the umbilical vein varix is an oval or elongated fluid-filled mass, oriented obliquely in the cephalocaudal direction, between the abdominal wall and the inferior edge of the liver. The clinical significance of this finding is unclear. It has been associated with an unexplained high mortality rate in utero, thrombosis of the varix leading to fetal death and other complications including hydrops fetalis. It had also been linked with chromosomal abnormalities.

Case report

We report a case of a 36-year-old woman (G1P0) presented at 28 weeks of gestation. Our ultrasound examination revealed a fetal intra-abdominal umbilical vein varix of 1.3 x 1.1 cm in diameter, localized close to the urinary bladder. Color Doppler revealed turbulent flow within the varix. At 36 weeks, a healthy female infant was delivered (2,835 g, Apgar scores 8, 9 in the 1st and 5th minutes, respectively).

Images 1, 2: Image 1 shows a transverse scans at the level of fetal intra-abdominal dilated part of the umbilical vein (red arrow) at 28 weeks of gestation (VB - gallbladder).

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Images 3, 4: Transverse views of the umbilical vein varix at 28 weeks of gestation. Color Doppler flow turbulent flow within the varix.

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