Case of Umbilical Granuloma: Diagnosis and Management

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Following is the case presentation of Umbilical Granuloma:

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 

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

Umbilical Granuloma : Management Options

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

In a systemic review of Eleven RCTs (n = 890) for the usage, effectiveness and side effects of silver nitrate, topical steroids, ethanol wipes, electrocautery, cryocautery, copper sulphate and common salt were included. Common salt was found to having achieved resolution in >90% of cases in five studies and 54-80% in two studies. Topical steroids, silver nitrate, copper sulphate and cryocautery were found to having achieved resolution in >90% and ethanol wipes in 50-65% of cases. However, local side effects reported with topical steroids, silver nitrate, cryocautery and electrocautery varied in each study. Salt application did not cause side effects. 

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Case of Umbilical Granuloma: Diagnosis and Management

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