[image: 29F Umblilicus.jpg]
Currently there is no visible mass or residual discharge.
She is big. The discharge started serous and became bloody, but was scant.
US was ordered to look for hernia. There is no umbilical hernia.
There is this sonographically visible lump at the umbilicus…..I honestly
didn’t know if it’s the umbilicus itself. And there are these echogenic
foci with some posterior shadowing…I don’t know if that’s
calcification or gas. I think it’s in, not trapped around the umbilicus.
And there is this flow on color doppler…that I honestly don’t know if
it’s normal or abnormal (I suppose I could look at my own….but I didn’t).
[image: 29F Umblilicus (1).jpg]
When I was scanning, I asked her what it looked like when there was pain
and discharge….so she showed me a picture on her phone.
[image: 29F Umblilicus (2).jpg]
It doesn’t look like that now.
But it looks alot like online pics of Umbilical Granuloma…which is much
more common in children, but can occur in adults, usually with trauma.
She did not try to get a navel piercing….and it seems like she’s amply
padded and protected against injury….but I don’t know.
I also see articles about papilloma…which can progress from granuloma.
There is this radiologic example of a urachal umbilical sinus that looks
sonographically similar radiopaedia.org/cases/urachal-umbilical-sinus-2
I am outside my comfort zone here! Does anyone have experience / expertise
in this? How should I report this?
Wouldn’t you consider an infected urachal remnant?
I have this old great article saved at the hospital but I can’t open it from here
doi.org/10.1148/radiographics.21.2.g01mr02451
I hope it can help.
🙂
Paolo
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