We report the case of a 22-year-old gravida 3, para 1 who was referred at 21 weeks gesta-tional age for an extended fetal anomaly ultrasound (US) examination because of an increased risk of congenital anomalies. Her first child was born with small gut atresia and a valvular stenosis of the pulmonary artery. During the US examination, an unusual appearance of the abdominal wall was seen. On transverse sonograms of the abdomen, a protruding part of higher echogenicity containing vessels was visualized, suggesting an omphalocele with extrac-orporeal liver (Figure 1). The abdominal circumference was within the normal range and the ribs extended to halfway of the abdomen. Despite a normal amount of amniotic fluid, the fetus remained in the left side of the uterus during the entire examination with little amniotic fluid surrounding the abdomen. In the sagittal plane, the thigh could be seen pressing against the lower abdominal wall due to flexion in the hip and knee joint. This position caused protrusion of liver tissue, giving a false impression of an abdominal wall defect in the axial plane. The diagnosis of exomphalos was therefore excluded. This was also corroborated by the normal umbilical cord insertion.
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