Abstract

Background: Umbilical discharge in an adult is uncommon and raises a wide range of diagnostic questions. Due to inherited disease such umbilical hernias and congenital anomalies, umbilical anatomy varies. Endometriosis or primary or metastatic cancer may spread to the umbilicus.
Present a case: A white American woman in her 40s who had been experiencing spontaneous umbilical bleeding for two days arrived at the clinic. Her periumbilical pain was accompanied by emesis and nausea. There were no skin abnormalities that could be seen, but a deep abdominal probing revealed a thin, watery serosanguineous fluid coming from the umbilicus. Five years before, she had a similar episode of unexplained umbilical haemorrhage. The results of the laboratory workup showed a slightly increased C-reactive protein. A full surgical excision of the umbilicus was required due to a fat-containing umbilical hernia with fat necrosis discovered by computed tomography imaging.
Conclusions: Adults with umbilical discharge should be evaluated for a rare disorder called an umbilical hernia with fat necrosis. Adults with spontaneous umbilical bleeding or discharge should also be evaluated for embryonal remains,omphalitis, and metastases as additional diagnostic possibilities. If the physical examination does not immediately reveal the cause, computed tomography imaging should be considered to check for hernias and embryonic defects.