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Journal of General Internal Medicine

, Volume 31, Issue 11, pp 1396–1396 | Cite as

Omphalolith: An Umbilical Concretion to Recognize

Clinical Practice: Clinical Images
First Online:
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KEY WORDS

clinical image dermatology dementia 
An 83-year-old woman with dementia presented with an umbilical lesion that was incidentally noticed by family. She had no abdominal pain, weight loss, or night-sweats. She did not know how long it had been present. On exam she had a painless, brownish-black, dry-appearing mass (Fig. 1) protruding from her umbilicus. The mass was felt to be an Omphalolith or Umbilical Concretion. It was removed with gentle traction using forceps. It measured 3.5 × 3.0 × 1.0 cm with a brownish-black dry-appearing cap and an inferior aspect that was pearly-tan-white (Fig. 2). Histopathology showed a specimen composed of laminated keratin.
Figure 1.

Omphalolith protruding from the umbilicus.

Figure 2.

Omphalolith after removal, with a dark brownish-black superficial cap and pearly-tan-white base.

The word Omphalolith (Omphalith) is derived from the Greek words omphalos (navel) and lithos (stone).1 It refers to sebum and keratin that have accumulated into a stone-like concretion in an umbilical cleft.2 Superficial parts of the Omphalolith can appear dark brown or black, likely due to melanin and oxidation of lipids.3 It is usually asymptomatic, but can come to attention with skin ulcerations or secondary infections.1 Omphaloliths likely form when the patient fails to clean a deep umbilical cleft. They are removed with gentle manipulation. Recognition of the entity is important to prevent unnecessary consultations, procedures, and imaging studies.

Notes

Compliance with Ethical Standards

Funding

None.

Conflict of Interest

The author declares that he does not have a conflict of interest.

REFERENCES

  1. 1.
    Ichiki Y, Kitajima Y. Omphalith. Clin Exp Dermatol. 2008;34:420–421.CrossRefPubMedGoogle Scholar
  2. 2.
    Gallouj S, Harmouch T, Amarti A, Fatima Z. Omphalolith: a rare entity but important to recognize. Dermatol Online J. 2014;20(5):14.Google Scholar
  3. 3.
    Sheehan D, Sarwat H, Vijayaraghavan G. Umbilical concretion. Radiol Case. 2011;5(4):25–31.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2016

Authors and Affiliations

  1. 1.Emergency Department, San Francisco VA Medical CenterSan FranciscoUSA
  2. 2.Department of Internal MedicineUniversity of CaliforniaSan FranciscoUSA

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