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Case of Umbilical Pyogenic Granuloma : Diagnosis and Management

Case History

A 2 year old male child presented with this moist and pink tissue popping out of the umbilicus.  Patient complained of  minimal amounts of drainage and irritation of the surrounding skin. This swelling started appearing from 3rd month. It was initially small but started growing in size gradually. Patient was initially advised topical application of silver nitrate but it did not resolve with conservative management. It was surgically excised.

Case of Umbilical Pyogenic Granuloma


Umbilical Granuloma

The umbilical cord normally separates within 3 days to 2 months postpartum; after separation, an excess of granulation tissue may persist at the base of the umbilical stump, which may aggregate and persist, for sometimes, to form an umbilical granuloma (UG). Umbilical granuloma is the most common umbilical problem in neonates and young infants.

Differential Diagnosis of Umbilical Granuloma

  • Patent urachus
  • Omphalomesenteric duct
  • Umbilical polyps 
  • Neoplastic swellings 

Management Options

  • Chemical cauterization with silver nitrate or copper sulphate.
  • Topical application of common salt / 82% ethanol or Clobetasolpropionte.
  • Electric cauterization.
  • Cryocauterization.
  • Surgical excision.

References:

http://pedemmorsels.com/umbilical-granuloma/

https://link.springer.com/chapter/10.1007%2F978-3-319-62383-2_27

https://www.jemds.com/latest-articles.php?at_id=6697

https://emedicine.medscape.com/article/935618-treatment

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