From the Guidelines
Umbilical drainage in adults is a significant finding that warrants prompt medical evaluation due to the potential for underlying infections or abnormalities. The presence of drainage from the umbilicus (belly button) can be indicative of various conditions, including umbilical granuloma, omphalitis (infection), or a urachal abnormality 1. It is essential to seek medical attention if drainage is noticed, as delayed treatment can lead to complications such as increased risk of infection, abscess formation, or even sepsis.
Causes and Treatment
The most common causes of umbilical drainage in adults include:
- Umbilical granuloma
- Omphalitis (infection)
- Urachal abnormality Treatment depends on the specific diagnosis but often involves:
- Cleaning the area with mild soap and water
- Keeping the area dry
- Applying prescribed topical antibiotics such as mupirocin or oral antibiotics like amoxicillin-clavulanate for infections
- Surgical intervention may be necessary to remove the source of persistent drainage, such as an infected umbilical cyst or sinus tract 1.
Importance of Prompt Evaluation
If drainage is accompanied by fever, increasing pain, redness, or foul odor, this suggests infection requiring immediate medical care. It is crucial to avoid attempting to squeeze or manipulate the area, as this can worsen infection and lead to further complications. The umbilicus connects to deeper structures during fetal development, and incomplete closure of these connections can create pathways for infection or persistent drainage in adulthood.
Management of Umbilical Catheters
In the context of umbilical catheters, it is recommended to remove them as soon as possible when no longer needed, with optimal removal within 5 days for umbilical artery catheters and up to 14 days for umbilical venous catheters if managed aseptically 1. However, the primary concern in adults with umbilical drainage is the underlying condition causing the drainage, rather than the management of umbilical catheters.
From the Research
Significance of Umbilical Drainage in Adults
The significance of umbilical drainage in adults can be attributed to various underlying conditions, including:
- Congenital conditions, such as urachal remnants 2
- Acquired conditions, such as umbilical pilonidal sinus 3, 4
- Infections, such as omphalitis 2
Causes of Umbilical Drainage
Umbilical drainage in adults can be caused by:
- Infection of the urachus, an embryological remnant that connects the umbilicus to the dome of the bladder 2
- Umbilical pilonidal sinus, a rare disease characterized by a sinus tract in the umbilicus 3, 4
- Other conditions, such as spontaneous umbilical drainage, which can be diagnosed and treated with basic laparoscopic skills and a careful office exam 5
Diagnosis and Treatment
Diagnosis of umbilical drainage in adults typically involves:
- Physical examination and detailed history 3
- Imaging studies, such as ultrasonography and CT scan of the abdomen and pelvis 2 Treatment options depend on the underlying cause and may include:
- Antibiotics and incision and drainage of the umbilical abscess 2
- Surgical excision of the affected portion, with or without reconstruction of the umbilicus 3, 4