Summary about Disease
An umbilical sinus is a persistent connection between the umbilicus (belly button) and either the bladder (urachal sinus) or the small intestine (omphalomesenteric duct sinus or vitelline sinus). It occurs when these structures, which are present during fetal development, fail to close completely after birth. This can lead to drainage, infection, and other complications.
Symptoms
Persistent drainage from the umbilicus (clear, serous, or purulent fluid)
Redness or swelling around the umbilicus
Foul odor from the umbilicus
Formation of a small, moist lump or growth at the umbilicus
Recurrent umbilical infections
Abdominal pain (less common, but possible if the sinus is deep or infected)
Causes
Umbilical sinus is caused by the incomplete closure of either the urachus (connecting bladder to umbilicus) or the omphalomesenteric duct (connecting small intestine to umbilicus) during fetal development. These structures normally obliterate before birth. Failure to do so results in a sinus tract extending from the umbilicus.
Medicine Used
Antibiotics: Used to treat infections associated with the sinus. The specific antibiotic will depend on the type of bacteria causing the infection. Common options include oral or topical antibiotics.
Silver nitrate: Occasionally used to cauterize small, persistent granulation tissue at the umbilicus.
Pain relievers: Over-the-counter pain relievers like acetaminophen or ibuprofen may be used to manage any discomfort. Note: Treatment often involves surgical removal of the sinus tract to prevent recurrence.
Is Communicable
No, an umbilical sinus is not communicable. It is a congenital condition (present at birth) resulting from developmental abnormalities and is not caused by an infectious agent.
Precautions
Keep the umbilical area clean and dry.
Clean the umbilicus gently with mild soap and water.
Avoid irritating the area with harsh chemicals or tight clothing.
Monitor for signs of infection (redness, swelling, pus, foul odor).
Seek medical attention if you suspect an infection or if drainage persists.
Follow your doctor's instructions for wound care after any procedure (e.g., silver nitrate cauterization or surgery).
How long does an outbreak last?
An "outbreak" isn't quite the right term. The sinus itself is a persistent condition. However, infections related to the sinus can occur intermittently. An infection can last from a few days to a few weeks depending on the severity and treatment. If the sinus is not surgically removed, infections can recur.
How is it diagnosed?
Physical examination: A doctor will examine the umbilicus to look for drainage, redness, swelling, or other abnormalities.
Sinography (fistulogram): A contrast dye is injected into the sinus tract, and X-rays are taken to visualize the extent and direction of the tract.
Ultrasound: May be used to visualize the sinus tract and any associated fluid collections.
CT scan or MRI: In some cases, these imaging studies may be necessary to further evaluate the sinus tract and rule out other conditions.
Culture of drainage: If there is drainage, a sample may be cultured to identify any bacteria causing an infection.
Timeline of Symptoms
At birth or shortly after: The sinus may be immediately apparent with drainage from the umbilicus.
Infancy/early childhood: Intermittent drainage or infections may occur. The condition might be discovered during routine check-ups.
Later childhood/adulthood (less common): If the sinus is small and asymptomatic, it might not be discovered until later in life, possibly triggered by an infection or other irritation. The timeline of recurrence is dependent on if the sinus is removed surgically.
Important Considerations
Umbilical sinuses can increase the risk of umbilical infections and require prompt treatment.
Surgical excision of the sinus tract is often recommended to prevent recurrent infections and other complications.
Early diagnosis and treatment are important to minimize potential problems.
A persistent umbilical discharge in a newborn or infant should always be evaluated by a healthcare professional.
While generally benign, there is a very small risk of malignancy arising in a persistent urachal remnant (specifically urachal cancer), especially in adulthood.