A 32-year-old hairy male presented to the out-patient clinic with complaints of pain and foul-smelling bloody discharge from umbilicus of 2 weeks duration. There was no history of any foreign body insertion, systemic symptoms or a similar history in the past. On examination, the umbilicus was deep with periumbilical cellulitis, edema and a foul-smelling bloody discharge. On probing, a ‘stony hard foreign body’ was felt. It was gently separated all around and was scooped out (Fig. 1) and was found to be an umbolith. The underlying abscess was drained and unhealthy tissue debrided. Local antibiotic cream (Fusidic Acid 2 %) was applied and prescribed. Pus culture grew Staphylococcus aureus which was sensitive to Fusidic Acid. Patient was advised on good personal hygiene and made an uneventful recovery and is well now.
Umbilical discharge in adult is rare, can be quite alarming and could be congenital or acquired, but is usually caused by a foreign material, most commonly hair. Obesity, deep umbilicus and poor hygiene seem to be the predisposing factors. Embryonal anomalies, such as patent urachus/vitelline duct, urachal cyst or sinus, vitelline cyst or sinus may present as umbilical discharge . However, the most common causes of umbilical discharge in adults are acquired conditions: hair tufts with infection, pilonidal sinus and foreign bodies . Rare causes include endometriosis and metastatic carcinoma . Most of the patients are young, hairy males with deep umbilicus with poor personal hygiene, as our patient. Removal of the foreign body with local antibiotic therapy should be done with an advice to proper personal hygiene.
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Rodrigues, G. Umbolith: a cause of umbilical discharge and omphalitis. Infection 43, 625 (2015). https://doi.org/10.1007/s15010-015-0775-9