Swelling around the umbilicus

Introduction 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

1. Pathogenic bacteria: Staphylococcus aureus is the most common pathogen, followed by Escherichia coli and hemolytic streptococcus. According to reports, the main pathogens of socially acquired infections are Gram-positive cocci (67.2%); while in hospital-acquired infections, Gram-negative bacilli are the main pathogens (56.8%).

2. Causes of infection

(1) Acute navel inflammation:

1 neonatal umbilical corditis: the main causes of umbilical cord infection in newborns are: contamination after umbilical cord ligation after birth or dressing contaminated by feces and urine before umbilical cord detachment; premature rupture of amniotic membrane, contamination of umbilical cord before birth; umbilical cord is produced during childbirth Bacterial contamination in the tract; contaminated by urinary tract or yolk sputum effluent; infection secondary to umbilical cord or umbilical sinus.

2 adult umbilical corditis: the umbilical fossa is deep and the skin on the underside is wrinkled. The dirt and sebum remain, which is not easy to be cleaned locally, or inadvertently scratched during descaling, causing bacteria to invade and cause infection.

(2) Chronic umbilical inflammation: acute umbilical inflammation is not cured, prolonged to chronic umbilical inflammation and umbilical granuloma; umbilical cord premature detachment leaves unhealed wounds; long-term chronic stimulation of foreign bodies (such as talcum powder) in umbilical fossa can cause Umbilical inflammation is delayed and forms umbilical granuloma.

(two) pathogenesis

After the pathogen invades the umbilicus, the early stage is limited to local infection. If the inflammation is not controlled, the range of inflammation is enlarged, and the abdominal wall cellulitis is present. The spread of infection along the lymph can cause widespread infection of the upper and lower abdominal wall and even the lower chest. Umbilical abscess may form after the infection is limited. If it is deep, it may cause peritonitis. Neonatal infection can still enter the blood through the umbilical cord, vein, and portal vein inflammation, portal vein embolism or sepsis. If the thrombus extends to the portal vein, it can lead to portal vein obstruction, resulting in extrahepatic portal hypertension. If the local wound healing is poor after the umbilical cord is broken, and the small granuloma remains, there is often secretion, which is chronic umbilical inflammation.

an examination

Related inspection

Umbilical examination abdominal MRI examination abdominal CT abdominal plain film

The diagnosis of umbilical inflammation is not difficult. According to the umbilical redness, secretions, and sometimes granuloma can be seen, long-term secretion can be diagnosed. The total number of peripheral blood leukocytes and neutrophils can support the diagnosis. If you suspect that the septicemia caused by umbilical inflammation, it can be supplemented with blood culture examination.

Differential diagnosis

1. Umbilical sinus: caused by the umbilical end of the yolk tube is not closed.

2. Umbilical intestinal fistula (the yolk tube is not closed): a bright red mucous membrane with a rounded protrusion at the umbilicus. There is a mouth in the middle, there is a odor discharge or liquid feces, oral charcoal or a contrast agent injected into the umbilicus. X-ray examination can confirm the diagnosis. Need surgery.

3. Umbilical urethral fistula (umbilical ureteral obstruction): The umbilicus often has clear liquid outflow, local injection of contrast agent can enter the bladder or bladder retrograde angiography to reach the skin, injecting methylene blue to the umbilicus to discharge blue urine. Need surgery.

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