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Umbilical Calculus

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

Umbilical fistulas

  • 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


Urachus

  • 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.
  • Endometrioma
    • 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.