From the Research
Ultrasound is the best initial investigation for umbilical discharge. This is based on the most recent and highest quality study available, which emphasizes the importance of ultrasound in diagnosing urachal anomalies and other causes of umbilical discharge 1. Ultrasound provides excellent visualization of the umbilical region and can identify common causes such as umbilical granuloma, patent urachus, or omphalomesenteric duct remnants. It is non-invasive, does not use radiation, is readily available in most healthcare settings, and is cost-effective compared to MRI. Some key points to consider when evaluating umbilical discharge include:
- Ultrasound can detect fluid collections, abscesses, or sinus tracts that may be causing the discharge
- Clinical examination findings and cultures of the discharge should also be considered to guide appropriate treatment
- If the ultrasound findings are inconclusive or if a more complex anatomical abnormality is suspected, then MRI may be considered as a second-line investigation
- MRI offers superior soft tissue contrast and can better delineate the extent of complex anomalies, but it is more expensive, less accessible, often requires sedation in young children, and is generally unnecessary for most cases of umbilical discharge 2, 1. The use of ultrasound as the initial investigation for umbilical discharge is supported by several studies, including a 2021 review of umbilical venous catheter placement, which highlights the importance of ultrasound guidance in reducing complications 3. Additionally, a 2019 case report emphasizes the role of ultrasound in diagnosing infected urachal cysts 4. Overall, the evidence suggests that ultrasound is the best initial investigation for umbilical discharge, due to its non-invasive nature, availability, and cost-effectiveness.