Umbilical Abscess Research Articles

Umbilical Discharge

An umbilical discharge is itself not a disease, but it is a symptom of many diseases. In children, it may be found to be associated with an underlying congenital abnormality like persistent OMD (Omphalo-mesenteric Duct) or Vitelline cysts or sinuses or umbilical granuloma or a diverticulum like the Meckel’s diverticulum which may possess ectopic gastric or pancreatic or even colonic mucosa, or the persistent allantois or a urachal cyst or an infected urachus etc. Umbilical discharge though rare in adults, it may be caused by diverse congenital or acquired conditions. The most common causes of umbilical discharge in adults are such acquired conditions as pilonidal sinus disease, infection of hair tufts and foreign bodies4, and specific and non-specific acute and chronic inflammation and abscess of the umbilicus, infected omphalolith etc. Very rarely the discharge may be due to endometriosis or metastatic carcinoma, umbilical hernia ulceration etc. Discharging umbilical abscess may be caused by bacteria that can enter as a result of penetrating trauma, rupture of the bowel, or abdominal surgery. Irrespective of aetiology, umbilical discharge is a distressing condition for the patient and the family members. Appropriate diagnostic aids and successful management strategies are now available. If not associated with malignant diseases or irreversible complications, the prognosis is excellent. KYAMC Journal Vol. 13, No. 01, April 2022: 50-55

Chronic umbilical abscess secondary to a patent urachus in a 30 years male: a case report

Urachus is epithelialized, fibromuscular remnant part connecting urinary bladder with umbilicus. Urachal anomalies present and progress differently in paediatric and adult population. They remain largely asymptomatic until infected. Clinical presentation may vary from simple discharge from umbilicus to intrabdominal abscess and peritonitis. We present a case of urachal sinus presenting as recurrent umbilical abscess. 30 years male presented with complaints of umbilical mass with pus discharge. He was evaluated clinically and radiologically. Ultrasound revealed a localized collection near umbilicus whereas CT scan revealed connection of that collection to a fibrous strand like structure approximately 10 cm extending from umbilicus to urinary bladder. An open exploration was done under regional anaesthesia and 20 ml of abscess drained with excision of tract by ligating near the bladder end. Local debridement was done near the umbilical area. Wound closed in layers. Post-op period was uneventful without any recurrence. urachal anamolies need a high index of suspicion in adults to intervene early and get better outcomes with less morbidity.

Retro Umbilical Abscess Mimicking Infected Urachal Cyst: A Rare Presentation from Migratory Fish Bone Ingestion

Retro Umbilical Abscess Mimicking Infected Urachal Cyst: A Rare Presentation from Migratory Fish Bone Ingestion

Patent vitellointestinal duct presenting as an umbilical abscess: a novel operative approach to a rare adult presentation.

Patent vitellointestinal duct presenting as an umbilical abscess: a novel operative approach to a rare adult presentation.

Urachal Sinus Complicated by an Umbilical Abscess

The urachal sinus is a vestigial remnant that ensues in the aftermath of incomplete obliteration of the embryonic urachus. Urachal sinuses often remain asymptomatic, being discovered incidentally in instances where they are complicated with a superimposed infection or abscess. Due to their rare occurrence in adults, urachal sinuses are rarely included in the list of differential diagnosis surrounding umbilical pain in adult patients. We hereby delineate a unique case of a urachal sinus in a 26-year-old male patient. Due to the presence of an abscess in a hirsute male, a presumptive diagnosis of an umbilical pilonidal sinus was suspected. However, further diagnostic workup divulged an unequivocal diagnosis of a urachal sinus complicated by an abscess formation.

Umbolith with umbilical abscess and omphalitis: a rare case

Umbolith is a relatively rare entity under normal circumstances, especially in the urban scenario. Usually seen in obese individuals with a deep and retracted umbilicus due to constant accumulation of sebum/keratin leading to stone formation. It’s usually covert until complicated by secondary infection (abscess) or ulceration. Sinus was laid open and healthy granulation was seen within 1st week. Pus culture sensitivity suggestive of heavy staph growth and antibiotics were given accordingly. Appendicitis was treated conservatively.

A 50-YEAR REVIEW ON THE PREVALENCE OF CLINICAL DISEASES AND DISORDERS OF CATTLE IN BANGLADESH

Background: The 25.7 million cattle populations in Bangladesh which is endangered by different diseases and disorders that are associated with significant socio-economic losses to the smallholder farmers and even in modern dairy farms. More than 100 articles on the retrospective evaluation of clinical case records have been published during the last 50 years from 1968 to 2018 in Bangladesh and their compilation and evaluation would help to understand the predominant diseases associated with morbidity and mortality. Objectives: To analyze and evaluate the 50-year data on the prevalence of clinical diseases and disorders of cattle to identify the predominant and priority ailments for their prevention and control. Materials and Methods: Data obtained from all the available 118 articles published on clinical cases of cattle during the last 50 years in Bangladesh were analyzed to detect their status on bovine health. Results: Out of 137 different types of clinical cases recorded during the last 50 years, of which, calves affected with 27 (19.71%), adult cattle with 76 (55.47%) and both calves and adult cattle with 34 (24.82%) types of diseases and disorders. The highly statistical significant (p < 0001) percentage of clinical cases of cattle required medicinal treatment (81.19%) in comparison to surgical (10.03%) and gynaeco-obstetrical (GO; 08.78%) intervention. Results revealed that the parasitic diseases (fascioliasis 66.16%, humpsore 22.35%, gastro-intestinal (GI) nematodiasis 17.44%, ascariasis 12.17%, tick infestation 15.71%) and GI disorders (anorexia 14.90%, indigestion 6.15%) were highly prevalent as clinical cases in comparison to infectious diseases (anthrax 0.21%, BQ 0.92% and HS 0.45%) except FMD (10.13%) and mastitis (6.46%). Anestrus (3.04%), retained placenta (2.73%), repeat breeding (2.73%) and pyometra (2.12%) were recorded as major gynaeco-obstetrical problems, whereas umbilical myiasis (10.11%), lameness (4.25%) and abscess (1.15%) that mainly required surgical interventions. Conclusions: The analysis of 50-year published reports on clinical cases of cattle gives an overall comprehensive idea about the disease problems that would help to formulate the devices for their prevention and control. Keywords: Prevalence, Clinical diseases and disorders, 50-year review, Calf diseases, Adult cattle diseases, Medicinal cases, Gynaeco-obstetrical cases, Surgical cases

Patent Vitellointestinal Duct Presenting as a Paraumbilical Abscess Along with Intestinal Obstruction in an Adult: a Case Report

The persistence of embryonic vitelline duct occurs in about 2% of the population. Patent vitellointestinal duct (VID) is a rare condition in adults. This anomaly may remain asymptomatic throughout life or may present with umbilical sinus, abscess, fistula, intussusception, and various other intraabdominal complications. We present here an interesting case of 32-year-old man with patent VID presenting as paraumbilical abscess along with intestinal obstruction caused by marked inflammatory changes and adhesion. This patient was managed successfully with excision of the entire duct along with the wedge of ileal attachment. Such rare presentation in an adult has not been reported earlier to the best of our knowledge. Simple incision and drainage of abscess without excision of patient VID would not result in complete treatment of this condition. Therefore, surgeons and radiologists should have high index of suspicion of this uncommon presentation as it is likely to be missed.

A Case of Umbilical Abscess due to Mycobacterium <i>Abscessus</i> Subspecies <i>Abscessus</i> that Appeared after Laparoscopic Cholecystectomy

A Case of Umbilical Abscess due to Mycobacterium <i>Abscessus</i> Subspecies <i>Abscessus</i> that Appeared after Laparoscopic Cholecystectomy

Clinical and laboratory investigation on the recurrence of the umbilical hernia after herniorrhaphy in bovine calves

This study was performed to investigate the recurrence of the umbilical hernia in bovine calves at Veterinary Teaching Hospital (VTH), Bangladesh Agricultural University, Mymensingh. A total of 34 animals were admitted to VTH diagnosed to have the umbilical hernia, among them 13 were recurrent cases. The diagnosis of umbilical hernia was based on the disease history, clinical signs, palpation, needle exploration, and auscultation. The risk factors like age, sex, breed, body weight, the season of affection, size of the hernial ring, suture materials, error in suture patterns and involvement of infections in the recurrence were considered. Infected samples were collected from recurrent patients with infected umbilicus region, and subjected to bacteriological analysis. We found the recurrence percentage was higher in the crossbred (44%) than that in the indigenous (22.22%) calves. It was also observed that recurrence percentage was higher in male (42.11%) than those in female (33.33%) patients. The recurrence percentage was also higher in calves aged below three months (40.74%) than the calves of above three months (28.57%). It was found that recurrence percentage was most frequent in summer (46.15%) and the least in the winter (30%). Among 13 recurrent bovine calves after herniorrhaphy, three calves returned to VTH with umbilical abscess, six calves recurred due to non-infectious causes like failure of suture materials, errors in suture pattern or management fault and 4 calves recurred with both umbilical abscess and non-infectious causes. From this study, it may be concluded that synthetic absorbable suture materials with secured suture pattern and good postoperative management may help in reducing the recurrence of an umbilical hernia.
 J. Bangladesh Agril. Univ. 16(3): 464–470, December 2018

Prevalence of umbilical hernia of calves and its risk factors at Tangail Sadar of Bangladesh

This study was done to investigate the prevalence of umbilical hernia of calves and its risk factors during the period from July, 2012 to January, 2013 at Tangail Sadar Upazila of Bangladesh. A total number of 1053 animals were examined during the study period where diagnosis based on the clinical history, clinical signs, palpation, needle puncture, auscultation. Then the animals was subdivided into some risk factors such as age, sex, breed, history of umbilical infection which may be lead to umbilical hernia. It was observed that male (61.10%) were in more risk than that of female (38.90%). In case of male calves maximum occurrence of the disease were in the age group of 1-3 months (45.45%) followed by <01 month of age group (36.36%) and least occur in 3-6 months of age group (18.18%) and in case of female calves maximum occur in the age of 1-3 months (71.43%) followed by in the age group of <01 month and 3-6 months (14.29%). The occurrence of umbilical hernia was more common in crossbreed calves (77.78%) than that of indigenous calves (22.22%). In case of crossbreed animals, male calves (44.44%) were more susceptible than in female calves (33.33%). In case of indigenous animals, male and female calves (11.11%) are more or less equally susceptible to the disease. In this study other umbilical infection likes umbilical abscess and navel ill which enhance the probability of occurrence of umbilical hernia, although it may be inherited in a dominant or recessive mode.
 Asian Australas. J. Biosci. Biotechnol. 2017, 2 (2), 154-158

Occurrence of common surgical affections in calves and goats at Jhenidah Sadar Upazila of Bangladesh

The occurrences of different surgical affections are very common in Bangladesh. The aim of this study was to determine the occurrence of most common surgical affections and their risk factors in calves and goat at Jhenidah Sadar Upazila of Bangladesh during the period from July to December 2011. Thirty seven (37) calves and twenty two (22) goats were used for this study. All animals were brought to hospitals with the complaints of surgical conditions. In this study we found umbilical hernia (59.5%), umbilical abscess (10.8%), atresia ani (8.1%), intestinal prolapse (2.7%), fracture of jaw (2.7%), necrosis of eyeball (2.7%), congenital polypus (2.7%), naval myiasis (5.4%) and abscess (5.4%) in calves. In case of goats, gid disease (36.4%), testicular hernia (4.5%), subcutaneous cyst (13.6%), atresia ani (4.5%), myiasis (9.1%), block of urethra (4.5%), fracture (9.1%), stitch abscess (9.1%), abscess (4.5%) and hematocele (4.5%) were recorded. The young, male and crossbred calves were showed more affections than that of adult and female. It was also found that the young male goats were more significantly (p<0.05) prone to surgical affections than that of adult and female. The male calf with 1-3 months of age (84.6%) were higher than that of male with age <1 month (70.8%). In both calf and goat, the female were found comparatively lower rate of surgical affections than male. However, further extensive work is very imperative to identify the specific cause as well as any factors that may influence region to region. Asian Australas. J. Biosci. Biotechnol. 2016, 1 (2), 394-397

The science of paediatrics, child health research, and the Royal College of Paediatrics and Child Health

Having completed a five year term as Science & Research Vice President of the Royal College of Paediatrics and Child Health (RCPCH), I offer a personal reflection. I explain why...

Peritoneal Dialysis–Related Peritonitis Caused by Erosion of Umbilical Abscess into the Peritoneal Cavity

Peritoneal Dialysis–Related Peritonitis Caused by Erosion of Umbilical Abscess into the Peritoneal Cavity

Comparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study

EUS may be used to reduce the need of diagnostic ERCP. Our purpose was to investigate the benefits and safety of an EUS-guided versus an ERCP-guided approach in the management of suspected biliary obstructive diseases caused by choledocholithiasis, in whom a US study is not diagnostic. A randomized study. A university medical unit. Patients with clinical, biochemical, or radiologic suspicion of biliary obstruction. In the EUS group, therapeutic ERCP was performed at the same EUS session if a lesion was found. In the ERCP group, therapeutic treatment was carried out at the discretion of the endoscopist. The number of ERCPs avoided, procedure-related complications, and recurrent biliary symptoms on follow-up at 1 year. Thirty-three patients were randomized to EUS and 32 to ERCP. Three patients (9.4%) had failed ERCPs, whereas all EUS procedures were successful. Nine (27.3%) patients in the EUS group were found to have biliary lesions that were all treated by ERCP. In the ERCP group, 7 (22%) patients had biliary lesions detected that were treated in the same session. More patients had serious complications (bleeding, acute pancreatitis, and umbilical abscess) in the ERCP group. One patient in each group had recurrent biliary symptoms during follow-up. With EUS used as a triage tool, diagnostic ERCP and its related complications could be spared in 49 (75.4%) patients. In patients suspected to have biliary obstructive disease, EUS is a safe and accurate test to select patients for therapeutic ERCP.

Surgical treatment for different forms of hernias in sheep and goats

Sheep and goats are frequently presented with different forms of hernias to veterinary clinics. The aim of this study is to investigate the outcome of the surgical treatment of abdominal, umbilical, inguinal and scrotal hernias in sheep and goats. Fifty-eight clinical cases (sheep = 44, goat = 14) were presented to the Veterinary Teaching Hospital, College of Agriculture and Veterinary Medicine, Qassim University, Saudi Arabia from September, 2003 to September, 2006. These animals had abdominal (sheep = 30, goat = 10), umbilical (sheep = 6, goat = 4), inguinal (sheep = 7) and scrotal (sheep = 1) hernias. All the cases of hernias in sheep and goats were subjected to full study including the history of the case, classification of hernias, the size of the hernial ring, surgical repair of the hernias, adhesions between the hernial sacs in each case, the postoperative care and follow up of the cases. The results revealed that gender had an effect on the incidence of hernia. The incidence of abdominal hernias was higher in females and the incidence of inguinal hernia was higher in males. There was a positive correlation between the history of hernia and the degree of adhesion. For the sheep, 26 out of 30 cases of abdominal hernia had good outcomes and the healing was excellent. There were postoperative complications in 4 ewes. For the goats, there were slight swellings at the site of operation in 2 out of 10 cases of abdominal hernia, while the remaining 8 cases had good outcomes. There was one case of umbilical hernia with an umbilical abscess that had broken down with sepsis formation at the surgical site. In conclusion, the success rates of surgical treatment for all types of hernias were very high and there were no significant differences in the success rates among the different types of hernias in both sheep and goats. The types of suture materials and the types of hernias had no significant effect on the outcome of the surgical treatment.

Umbilical perforation: an unusual complication of a ventriculoperitoneal shunt

Ventriculoperitoneal shunt operations are the most common pediatric neurosurgical procedures in the treatment of hydrocephalus. However, ventricular shunting is frequently associated with a wide variety of complications. Umbilical perforation is an extremely rare complication of ventriculoperitoneal shunts. We present an infant with umbilical abscess, meningitis, and umbilical perforation of the distal end of the ventriculoperitoneal shunt, which was placed for congenital hydrocephalus.

The outcome of unretrieved gallstones in the peritoneal cavity during laparoscopic cholecystectomy. A prospective analysis.

Gallbladder perforation during laparoscopic cholecystectomy (LC) with spillage of bile and gallstones occurs in a substantial number of patients (up to 40%). Most surgeons believe that free intraperitoneal stones are not a justification for conversion to laparotomy even if a large number of stones are left in situ. There are, however, a number of reports demonstrating that, on occasion, these unretrieved gallstones may cause infection or abscess, inflammation, fibrosis, adhesions, cutaneous sinuses, small bowel obstruction, or generalized septicemia. The aim of this study was to determine the outcome of unretrieved gallstones in the peritoneal cavity after gallbladder perforation during LC. In a 7-year period between 1989 and 1996, prospective data were maintained on 856 patients who underwent LCs by a single surgeon (R. J.F.). Of the 856 patients, 165 (16%) had gallbladder perforations resulting in lost gallstones in the peritoneal cavity. A concerted attempt was made to remove the lost stones using a variety of extraction devices. Of these 165 patients, 106 (64%) were available for follow-up through mail (76%) and by telephone (24%). The mean age of these patients was 64.9 years (range, 18 to 98 years), and the mean follow-up was 44.8 months (range 4.9 to 92.3 months). Of the 106 patients with unretrieved gallstones, we identified four patients with short-term complications and one patient with a long-term complication. The first patient with a short-term complication had pyrexia for 10 days postoperatively. Diagnostic evaluation, which included computed tomography (CT) scan, failed to reveal any abnormality. The patient was treated conservatively with a course of oral antibiotics. In the second patient, cellulitis developed at a drain site after its removal, which resolved with oral antibiotics. The third patient acquired an umbilical wound abscess, which drained spontaneously, requiring no treatment. A sterile subphrenic collection developed in the fourth patient 1 month postoperatively, which was treated with percutaneous drainage under CT guidance. The only long-term complication was spontaneous erosion of a gallstone from the back of a patient with a questionable history of inflammatory bowel disease 8 months postoperatively. All of the patients made complete recoveries. In most patients, unretrieved gallstones are of no consequence, but complications occur occasionally. It is therefore advisable to retrieve as many gallstones as possible during LC short of converting to a laparotomy.

Effects of and factors associated with umbilical hernias in a swine herd

Summary Of 2,958 pigs from a 320-sow, farrow-to-finish herd that were evaluated from birth to slaughter, 44 (1.5%) developed umbilical hernias. Hernias were detected mostly (34/44) when the pigs were between 9 and 14 weeks of age and were not fatal despite lack of treatment. Among littermates, weight gain prior to weaning was significantly (P = 0.04) lower in pigs that developed hernias (144.7 g/d) by 30 weeks of age than for nonaffected pigs (163.3 g/d), but growth rates from weaning to about 45 kg did not differ significantly. Records of pigs sired by 13 purebred boars were used to evaluate breed-of-sire associations. Pigs sired by American Spotted (n = 19; relative risk [rr] = 8.3; 95% confidence interval [ci] = 2.1 to 32.7) and Duroc boars (n = 378; rr = 2.1; 95% ci = 1.0 to 4.5) were more likely to develop umbilical hernias than were pigs (n = 1,644) sired by Yorkshire boars. Umbilical lesions (omphalitis or umbilical abscess) were associated (rr = 7.6; 95% ci = 1.2 to 49.5) with umbilical herniation on an individual basis, but the association was not evident (rr = 1.2; 95% ci = 0.2 to 7.6) when the litter was the unit of analysis. Analysis of sire associations, stratified by umbilical lesion status, indicated increased risks in the nonlesioned stratum for the American Spotted (rr = 8.7) and Duroc sires (rr = 2.2). Adequate comparisons of sire breed in the lesioned stratum could not be made, because umbilical lesions were an infrequent finding (9/2,958). For Yorkshire-sired pigs, there was a 13.7 times higher risk (95% ci = 2.2 to 86.1) of umbilical hernias if the pig had an umbilical lesion earlier in life. Significant (P < 0.05) associations were not evident between umbilical hernia and sex, or prophylactic treatment with Oxytetracycline. Findings from the study provided support for genetic and infectious hypotheses for umbilical hernias.

3 cases of persistent urachus with umbilical abscess in Wistar rats.

3 cases of persistent urachus are described in a small colony of Wistar rats: 2 cases were from 1 litter, and all were in females. The condition presented as a swelling in the umbilical region and on microscopic examination showed an abscess with an epithelial-lined peduncle. The condition has not been described previously in the rat.