Umbilical calculus (Umbolith)
- Often black in colour, is composed of desquamated epithelium which becomes inspissated and collects in the deep recess of the umbilicus.
- Present with inflammation and often a blood stained discharge.
- Treatment is extract the calculus and to prevent its recurrence excise the umbilicus
- A slow leak from any viscus is liable to track to the surface at this point.
- Patent vitellointestinal duct or the urachus
- Enlarged inflamed gallbladder may perforate and discharge its content through umbilicus.
- The vitellointestinal duct occasionally persists and gives rise to one of the following conditions
- The umbilical fistula which discharges mucus and rarely faeces when duct is patent.
- An adenoma when a small portion of the duct near the umbilicus remain unobliterated, it give rise to a sinus that discharge mucus. If its epithelium become everted it will form an adenoma
- An intra-abdominal cyst, when intervening portion remains unobliterated
- An intraperitoneal band
- Meckel’s diverticulum
- A patent urachus present with urine coming through umbilicus
- Treat first the distal obstruction then needed umbilectomy and excision of the urachus up to bladder
Neoplasms of the umbilicus
- Umbilical adenoma or raspberry tumour
- Common in infants
- In cases of unobliterated vitellointestinal duct, mucosa prolapsing through the umbilicus gives rise to a raspberry-like tumour, which is moist with mucus and tends to bleed.
- Treated by exploration of abdomen under general anaesthesia and treat the underneath cause accordingly.
- Seen in women at menstrual age
- The umbilicus becomes painful and bleeds at each menstruation
- A small fleshy tumour in umbilicus may be apparent.
- Umbilectomy will cure the condition
- Secondary carcinoma
- At umbilicus is not uncommon and present late manifestation of the disease
- Primary neoplasm is often situated in the stomach, pancreas, colon or ovary and some times breast.