UMBILICAL Mass

Umbilical polyp. It is a rare anomaly, resulting from persistence of all or part of the omphalomesenteric duct {OMD} or the urachus. {1} Usually umbilical polyp represents only the distal remnant of OMD or the urachus. In such cases, it is present in absence of other OMD or urachal anomalies. Sometimes, it may be associated with other OMD anomalies like omphalomesenteric cyst, intestinal fistula or meckel’s diverticulum` or urachal remnants like urachal cyst, sinus or patent urachus. {2} Umbilical polyp must be differentiated from the much common umbilical granuloma. The latter appear as 1mm to 1cm pink friable lesions. Unlike umbilical granuloma, umbilical polyp does not respond to silver nitrate cauterization. {2} Most infants with umbilical polyps will have small amount of discharge, but significant and persistent discharge, particularly if it resembles intestinal content or urine, should suggest the possibility of co-existent vitelline or urachal remnants. {1,2} USG should be obtained and a fistulogram, sinogram may be occasionally useful in this setting. Histologically, the polyp consists of intestinal or urinary tract mucosa. Treatment is surgical excision of the polyp and the OMD or urachal anomalies, if associated. {1,2}

E-published: March 2012 Vol 9 Issue 3 Art # 14

References :

Pacilli M, Sebire NJ, Maritsi D, Kiely EM, Drake DP, Curry JI, et al. Umbilical polyp in infants and children. Eur J Pediatr Surg 2007; 17: 397-399 Pomeranz A. Anomalies, abnormalities, and care of the umbilicus. Pediatr clin North Am 2004; 51: 819-827