Differential Diagnosis of a Umbilical Abscess
The following differential diagnoses are organized into categories to help guide the diagnostic process.
- Single Most Likely Diagnosis
- Omphalitis: This is the most common cause of umbilical abscess, especially in newborns. It is an infection of the umbilical stump, which can progress to an abscess if not treated promptly.
- Other Likely Diagnoses
- Urachal abscess: The urachus is a remnant of the allantois, which is a structure that connects the bladder to the umbilicus during fetal development. If it remains patent, it can become infected and form an abscess.
- Umbilical granuloma: This is a small, inflamed nodule that can form at the base of the umbilical stump, often as a result of incomplete healing or infection.
- Foreign body reaction: Introduction of a foreign object into the umbilical stump can cause an inflammatory reaction, leading to abscess formation.
- Do Not Miss Diagnoses
- Appendicitis: Although rare, appendicitis can present with umbilical pain or tenderness, especially if the appendix is located near the umbilicus. Missing this diagnosis can lead to severe consequences, including perforation and peritonitis.
- Ovarian torsion: This is a gynecological emergency that can present with severe abdominal pain, including umbilical pain. Delayed diagnosis can result in loss of the ovary.
- Intestinal obstruction: Umbilical pain can be a symptom of intestinal obstruction, which requires prompt surgical intervention to prevent complications.
- Rare Diagnoses
- Patent urachus: A rare congenital anomaly where the urachus remains open, connecting the bladder to the umbilicus. This can lead to urinary tract infections, including umbilical abscess.
- Umbilical endometriosis: A rare condition where endometrial tissue grows in the umbilical scar, causing cyclic pain and bleeding.
- Desmoid tumor: A rare, benign tumor that can occur in the abdominal wall, including the umbilical region, and cause a palpable mass or abscess.