Abstract
Umbilical discharge in infancy is often attributed to infection or an umbilical granuloma. It is important to investigate if such a discharge is due to an underlying congenital abnormality because corrective surgical intervention may then be required. We present the first case of an infant with a persistent umbilical discharge from an omphalomesenteric duct cyst. The discharge was associated with periumbilical dermatitis. The dermatitis was most likely due to irritation of the skin by gastric acid produced by the ectopic gastric mucosa contained in the omphalomesenteric duct cyst. Both discharge and dermatitis resolved after surgical removal of the cyst.
Highlights
Umbilical disorders can result from failure of an embryologic process
If the lumen of the OMD has not completely disappeared at birth, various abnormalities can result including a fistula between the ileum and the umbilicus, an omphalomesenteric duct sinus emerging from the umbilicus and blind ending, a cyst representing a remnant of a patent segment of the OMD, a diverticulum whose enteric portion is patent, that is, Meckel’s diverticulum, or an umbilical polyp [1]
We present the case of an umbilical cyst lined with gastric mucosa discharging from the umbilicus through a sinus with fistula
Summary
Umbilical disorders can result from failure of an embryologic process. Basic understanding of the anatomy and embryology is necessary to identify and treat umbilical disorders. At 2 weeks of age, she attended a general practitioner surgery with discharge of watery liquid from the umbilicus, and it was treated like an umbilical granuloma with silver nitrate application. She came to the paediatric assessment unit of the local district general hospital at 3 weeks of age because of ongoing discharge. The child presented again with ongoing symptoms This time, it was diagnosed as excoriated umbilical granuloma with possible tinea corporis infection and she was treated with miconazole and neomycin. At 6 months of age, she was rereferred by the general practitioner for persistent umbilical discharge with intermittent blood-stained fluid whilst she had been on her third
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