From the Research
The best investigation of umbilical discharge involves a comprehensive approach starting with ultrasonography, as recommended by the most recent study 1, to rule out underlying anomalies such as patent urachus, omphalomesenteric duct remnant, or umbilical granuloma. This approach is crucial in determining the underlying cause of the discharge and guiding appropriate management.
- A thorough physical examination should be performed to assess the characteristics of the discharge and associated symptoms.
- Swab cultures of the discharge should be obtained to identify causative organisms, particularly Staphylococcus aureus, Streptococcus species, or gram-negative bacteria.
- Complete blood count may help evaluate for systemic infection.
- In persistent cases, MRI or CT scan may be necessary to better visualize the umbilical structures and potential intra-abdominal connections, as suggested by 2.
- For neonates and infants, evaluation should include assessment for omphalitis, while in adults, attention should be paid to potential umbilical hernias or pilonidal disease.
- Prompt investigation is important as umbilical discharge may indicate local infection requiring antibiotic therapy or surgical intervention for structural abnormalities. The investigation pathway should be guided by patient age, discharge characteristics, and associated symptoms to determine the underlying etiology and appropriate management, as emphasized by 1.