Umbilical Discharge - Digging Deeper!!

Umbilical Discharge is one of the most common concerns in newborns and a diligent approach to correct diagnosis simplifies things for clinician and parents.

#CONGENITAL#

1. Omphalomesenteric Remnants

Umbilical Cyst, Umbilical sinus with band, Umbilical Polyp, Umbilical cyst with MECKEL'S Band, MECKEL'S Diverticulum, Patent Omphalomesenteric Duct ( VID)

2. Urachal Remnants

PATENT URACHUS, URACHAL SINUS, URACHAL CYST

3. UMBILICAL HERNIA

#ACQUIRED#

1. Umbilical Granuloma

2. Omphalitis

Index case

2 months female with a fleshy mass over umbilicus and persistant watery discharge,not responding to medical management

Usg

S/ o

Umbilical Polyp with urachal Sinus without communication to urinary bladder.

On clinical examination: Bright polypoid mass with watery discharge and excoriation around umbilicus.

*Clear drainage from umbilicus should always raise suspicion of patent urachus*

Excoriation is most prominent accompanied feature because of urine dermatitis.

Clinch is mostly clinical along with assistance of a good ultrasonologist.

OPERATIVE FINDING

Umbilical polyp with a patent urachus extending to dome of bladder.

Excision done through infraumbilical approach.

HPE was consistent with presence of ectopic pancreatic and colonic tissue with no atypia.

Patent urachus rarely has potential for malignancy in retained ectopic tissue.

Excision of tract in toto is necessary.

I hope you find the discussion useful.

Kept it crisp and factual from clinical pount of view without going in individual details.