Hemispherical mass in the umbilicus

Introduction Umbilical circumference swelling: umbilical fossa is moist, swollen, oozing odor, may be purulent or mixed with blood is a clinical diagnosis of umbilical inflammation. Omphalitis is a bacterial infection of the umbilical stump. According to the age of onset, there may be adult ointment and neonatal umbilical inflammation. According to the pathological process, there are two kinds of acute omphalitis and chronic omphalitis. Acute umbilical inflammation is an acute cellulitis of the umbilical cord tissue. If the infection progresses, it may be complicated by abdominal cellulitis, or it may develop into a peri-umbilical abscess, and there is a risk of complicated peritonitis and sepsis. The pathogen is Staphylococcus aureus and the like. Chronic umbilical inflammation is a kind of chronic inflammatory manifestation of umbilical cord caused by irregular treatment, long-term unhealed or unhealed wounds and local foreign body stimuli after umbilical cord detachment.

Cause

(1) Causes of the disease

Insufficiency of umbilical ring insufficiency, weak umbilical tissue or atrophy of abdominal fascia muscle is the pathological basis of umbilical hernia. Increased intra-abdominal pressure caused by pregnancy, obesity, excessive omental fat, chronic cough, cirrhosis, ascites, etc. An important incentive.

(two) pathogenesis

In early childhood, the umbilical ring is closed, and a scar is formed locally, which becomes a weak part of the abdomen. In the middle-aged and multiple-pregnancy, the abdominal wall is more vulnerable due to partial degeneration or degeneration of the abdominal muscles. Therefore, when the abdominal pressure is high for a long time and the abdominal muscles are excessively stretched, the internal organs are removed from the weak part of the umbilical cord. The wall of the umbilical hernia and the coating layer are thin, and the contents of the sputum are like subcutaneous. Most of the contents were in the early omentum, followed by the small intestine and colon. There is often adhesion between the contents of the sputum and the umbilical hernia sac, forming a multi-atrial gap, and sometimes intestinal obstruction. Pregnant women or patients with cirrhosis and ascites, such as with umbilical hernia, sometimes have spontaneous or traumatic perforation.

an examination

Related inspection

Abdominal examination of laparoscopic abdominal vascular ultrasound

Clinical symptoms

1. Symptoms: Umbilical lumps, coughing and clumping when forced, disappear when lying down. Local pain or abdominal discomfort in the mass may be associated with indigestion. In the presence of incarceration, there may be incomplete or complete intestinal obstruction.

2. Physical examination: There are half spherical lumps in the umbilicus, soft and huge umbilical hernia can hang downwards. If the contents of the sputum are intestines, the peristalsis can be seen. When standing upright, the sacral protrusions, when lying down, the sputum recovers; there is a cough impact, back Naco touches the umbilical defect and the round ankle ring.

diagnosis

1. History: Learn more about the patient's history of multiple pregnancies, history of chronic cough, and ascites in cirrhosis.

2. Clinical features: reversible umbilical hemispherical mass; cough impact, can touch the umbilical defect and ankle ring.

3. Auxiliary examination: can exclude other diseases of the abdomen.

Differential diagnosis

Umbilical circumference swelling: umbilical fossa is moist, swollen, oozing odor, may be purulent or mixed with blood is a clinical diagnosis of umbilical inflammation. Omphalitis is a bacterial infection of the umbilical stump. According to the age of onset, there may be adult ointment and neonatal umbilical inflammation. According to the pathological process, there are two kinds of acute omphalitis and chronic omphalitis. Acute umbilical inflammation is an acute cellulitis of the umbilical cord tissue. If the infection progresses, it may be complicated by abdominal cellulitis, or it may develop into a peri-umbilical abscess, and there is a risk of complicated peritonitis and sepsis. The pathogen is Staphylococcus aureus and the like. Chronic umbilical inflammation is a kind of chronic inflammatory manifestation of umbilical cord caused by irregular treatment, long-term unhealed or unhealed wounds and local foreign body stimuli after umbilical cord detachment.

Infants and young children have prominent tumors in the umbilicus: infantile umbilical hernia is a congenital developmental deficient disease, which gradually decreases with age. Most can heal themselves within 2 years of age. The surface of the sputum has skin covering mainly in the umbilicus with a prominent mass, the mass is enlarged when crying, the skin tension is very thin, the micro-cyan is quiet, lying down or the tumor shrinks away during sleep, and the umbilicus has loose wrinkles.

Umbilical process: Amur bulging (acromphalus) is a common type of congenital abdominal wall malformation. It is due to congenital abdominal wall hypoplasia, forming a defect in the abdominal wall around the umbilical cord, leading to neonatal malformation of abdominal visceral prolapse. Because the disease is associated with chromosomal abnormalities, sick children may be accompanied by malformations of other organs while suffering from umbilical bulging. Improper mortality is high. Most of the sick children need surgery immediately after birth, otherwise it is difficult for the sick child to survive due to local skin ulceration, necrosis and infection. In a few cases, the capsule is gradually fibrillated to form a scar, which protects the viscera and prevents early death. The mortality rate of this disease is related to the treatment time. If necessary, surgery should be performed as soon as possible.

Umbilical sore: Symptoms are red and swollen in the umbilicus. The light is confined to the umbilicus. The severe one can spread to the surrounding area. It is even erosive, and the pus overflows. It has both fever, irritability, and red lips.

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