Differential Diagnosis for Large Amount of Drainage from the Belly Button

• Single Most Likely Diagnosis
  • Umbilical hernia with incarceration or strangulation: This condition can cause drainage due to the potential for bowel or other tissue to become trapped and necrotic, leading to infection and subsequent drainage.
• Other Likely Diagnoses
  • Umbilical sinus or cyst infection: These congenital anomalies can become infected, leading to purulent drainage from the belly button.
  • Omphalitis: An infection of the umbilicus, which can cause significant drainage, especially in newborns or after umbilical piercing.
  • Foreign body reaction: Introduction of a foreign object into the umbilicus can cause an inflammatory reaction, leading to drainage.
• Do Not Miss Diagnoses
  • Appendicitis with appendiceal rupture: Although rare, an appendix located near the umbilicus can rupture and cause drainage through the belly button.
  • Intra-abdominal shunt infection or malfunction: In patients with a ventriculoperitoneal shunt, infection or malfunction can cause drainage from the umbilicus.
  • Spontaneous bacterial peritonitis: In patients with cirrhosis or other causes of ascites, spontaneous bacterial peritonitis can cause umbilical drainage.
• Rare Diagnoses
  • Patent urachus: A congenital anomaly where the urachus fails to close, potentially causing urine drainage from the umbilicus.
  • Umbilical endometriosis: Endometrial tissue in the umbilicus can cause cyclical drainage, especially in women with a history of endometriosis.
  • Lymphoma or other malignancies: Rarely, malignancies can cause umbilical drainage due to tumor erosion or metastasis to the umbilicus.