From the Research
The best investigation of umbilical discharge involves a thorough physical examination followed by ultrasound examination of the umbilical region, 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.
- Initially, a complete history should be taken to determine the duration, character, and associated symptoms of the discharge.
- Direct visualization and swabbing of the discharge for culture and sensitivity testing is essential to identify potential bacterial pathogens.
- In cases where deeper structures are suspected to be involved, CT scan or MRI may be necessary for better visualization, as suggested by 2 and 3.
- Blood tests including complete blood count and C-reactive protein can help assess the severity of any infection.
- If granulation tissue is present, histopathological examination may be required to rule out rare malignancies. The use of ultrasound as an initial diagnostic modality is supported by 1, which reported its effectiveness in evaluating umbilical disorders. It is also important to note that the management of umbilical disorders may involve surgical excision, as recommended by 1, and that a stepwise approach is necessary to ensure proper identification of the underlying cause and appropriate management.
- The stepwise approach includes:
- Physical examination
- Ultrasound examination
- Culture and sensitivity testing
- Blood tests
- Histopathological examination (if necessary)
- CT scan or MRI (if necessary) This approach is essential in reducing morbidity, mortality, and improving quality of life, as it allows for the proper identification and management of the underlying cause of umbilical discharge.