Umbilical Disorders

Abstract

The most common abnormality of the umbilicus is the umbilical hernia. It occurs when the umbilical cicatrix fails to close following separation of the umbilical stump. Most umbilical hernias resolve spontaneously without treatment in the first few years of life. A chronically moist umbilicus following separation of the umbilical stump may be from an umbilical granuloma or ectopic bowel mucosa, or from a patent urachus (that leaks urine) or a patent vitello-intestinal (omphalomesenteric) tract (that leaks air and faecal fluid). Persistence of the vitello-intestinal tract may also produce melaena and anaemia, closed loop bowel obstruction and Meckel diverticulitis. The most severe umbilical abnormalities evident at birth are exomphalos (omphalocele) and gastroschisis, both of which can be life-threatening. Exomphalos often has associated congenital abnormalities whereas the associated problems in gastroschisis are mainly confined to the gut.