Omphalitis with Umbilical Abscess in an Adult with a Urachal Remnant

Abstract

Omphalitis is an inflammation of the umbilicus and is seldom diagnosed in adults. It is even rarer when it results from an infection of the urachus, an embryological remnant that connects the umbilicus to the dome of the bladder. Patients with omphalitis present with erythema, edema, tenderness, and purulent discharge form the umbilical stump. Workup includes ultrasonography and CT scan of the abdomen and pelvis. Management consists of antibiotics and incision and drainage of the umbilical abscess, followed by surgical resection of the urachal remnant. In this article, we report a case of omphalitis complicated by umbilical abscess in a 20-year-old female with a urachal remnant.

Keywords: Omphalitis; Umbilical abscess; Urachal remnant.

Fig. 1

Axial (a) and sagittal (b) enhanced images at the level of the umbilicus show a focal inflammation and localized abscess collection at the umbilicus and a tract in the abdominal wall measuring 3.3 × 2.4 cm, extending along 5 cm (yellow arrows). It is associated with infiltration of the surrounding fat plane, thickened skin, and a narrow umbilical neck (best seen on sagittal image, red arrow).

Fig. 2

a Transverse scanning over the umbilicus demonstrates a well-defined heterogenous area showing echogenic foci posteriorly representing air (red arrow). Re-demonstration of skin thickening (yellow arrow). b Longitudinal scanning over the umbilicus demonstrates a hypoechoic tract (green arrow).