From the Research
The best investigation of umbilical discharge involves a thorough physical examination followed by ultrasound examination as the initial diagnostic modality, as recommended by the most recent study 1. This approach is crucial in evaluating for underlying anomalies such as patent urachus, omphalomesenteric duct remnant, or abscess formation. In cases where the diagnosis remains unclear, CT scan or MRI may be necessary to better delineate the anatomy and identify any communication with intra-abdominal structures, as suggested by 2 and 1. Key steps in the investigation include:
- Direct visualization and culture of the discharge to identify potential pathogens
- Ultrasound examination as the first-line imaging modality
- Consideration of CT scan or MRI for further evaluation if necessary
- Blood tests, including complete blood count and C-reactive protein, to assess the severity of any infection This stepwise approach is essential because umbilical discharge can result from various conditions, ranging from simple umbilical granuloma to more complex congenital anomalies, and proper identification of the underlying cause guides appropriate management, as highlighted by 1, which is the most recent and highest quality study on this topic.