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PubMed1986

Repair of gastroschisis with preservation of the umbilicus.

A simplified technique for the repair of gastroschisis without the need to excise the umbilicus or make a fascial incision has been developed. First, the abdominal wall is stretched and the viscera are reduced. Next, the skin and subcutaneous tissue are elevated from the fascia for 1.5 cm around the defect and the fascia is closed transversely with interrupted sutures. The skin is also closed transversely. The umbilical stump is left intact. Eight of nine consecutive patients with gastroschisis were able to undergo repair by this technique. The average hospital stay was 35.6 days. There were no cases of omphalitis or cellulitis of the abdominal wall, but one child has a small umbilical hernia. All have a near normal-appearing umbilicus. This simpler technique for the repair of gastroschisis is quicker and less traumatic, and gives a better cosmetic result than the conventional method.

Abdominal Muscles↗
PubMed1971

Disinfection of the umbilicus for abdominal surgery.

Bacteriological investigation of the adult umbilicus showed that it is much more profusely colonised by bacteria than the rest of the abdominal skin. Routine preoperative treatment with alcoholic chlorhexidine solution did not disinfect the umbilicus satisfactorily. Better results were achieved by disinfection with povidone iodine followed by alcoholic chlorhexidine.

Abdomen↗
PubMed2004

[Adenocarcinoma of the umbilicus].

INTRODUCTION: Most of the umbilical neoplastic processes are metastatic whereas primary adenocarcinoma is scarce and hard to distinguish from a secondary process. Our observation illustrates this difficulty. OBSERVATION: A fifty year-old woman had developed chronic omphalitis over several years. She consulted for a multinodular, erythemato-violine, oozing and deep infiltrating tumor of the umbilicus which had been developing for two months. The anatomopathological exploration of a biopsy of the lesion suggested a clearly differentiated adenocarcinoma whose digestive origin was the most likely. Investigations for a primary neoplasm were negative. Polychemotherapy was efficient with eight months recline. DISCUSSION: Umbilical metastases are referred to as Sister Marie Joseph nodule. They essentially correspond to a metastatic localization of an intra abdominal adenocarcinoma. The major problem consists in distinguishing a Sister Marie Joseph nodule where the neoplasm remains indefinite from an adenocarcinoma developed from an embryonic remainder. The existence in our patient's case history of a chronic omphalitis developing for Years and the negative tests for a primary neoplasm suggest a primary adenocarcinoma of the umbilicus.

Abdominal Neoplasms↗
PubMed1999

Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus.

Laparoscopic cholecystectomy has become the gold standard in the care of patients with cholelithiasis. A standard laparoscopic cholecystectomy employs three trocar incisions outside the umbilicus, which are a source of potential wound complications and an undesirable cosmetic outcome. We describe here a modification of the laparoscopic cholecystectomy which utilizes two transumbilical trocars and two transabdominal gallbladder stay sutures and does not require abdominal wall incisions outside the umbilicus. When technically feasible, this technique results in superior cosmesis and may reduce postoperative wound complications.

Cholecystectomy, Laparoscopic↗
PubMed1995

Reconstruction of the umbilicus: a simple technique.

The author proposes a simple technique for umbilical reconstruction. The new umbilicus is represented by an island flap that is sunken and then sutured to a circular skin defect drawn at the intersection of the xiphoid-pubic line and the transverse umbilical line. Before sinking, an accurate excision of the subcutaneous fat of the skin island is performed. A natural-looking elliptical scar is obtained, without any additional scar and providing good aesthetic results. The technique proposed can provide a good alternative to existing umbilicus reconstruction techniques.

Humans↗
PubMed1977

Endometriosis of the umbilicus.

A 39-year-old woman with a history of prolonged and excessive vaginal bleeding and bleeding from the umbilicus was found to have umbilical endometriosis. The umbilicus was excised following hysterectomy and bilateral salpingo-oophorectomy. Umbilical endometriosis should be considered in the differential diagnosis of umbilical lesions.

Adult↗
PubMed1998

Intralymphatic embolic cells with cutaneous endometriosis in the umbilicus.

Endometriosis is defined as the presence of both functioning endometrial glands and stroma outside their usual location lining the uterine cavity. It has been identified in virtually all tissues and organs of the female body with the exception of the spleen. There have been many theories proposed regarding the etiology and pathogenesis of endometriosis. One is the transport of cells through lymphatics and blood vessels. A 44-year-old female suffering from an episode of endometriosis of the umbilicus, left inguinal, uterus, and bilateral ovaries in association with a Múllerian anomaly is presented. Histopathological findings of a skin biopsy from her umbilicus showed aggregated cells within the lymphatic vessel of the upper dermis. This case provides evidence suggesting that cutaneous endometriosis could occur by transport of endometrial cells through lymphatics or blood vessels.

Endometriosis↗
PubMed2000

Closure of the abdominal wall at the umbilicus and the development of umbilical hernias in a group of foals from birth to 11 months of age.

The closure of the body wall defect at the umbilicus was studied in relation to the development of umbilical hernias in a group of 44 normal foals, 25 of which were followed from birth until five months of age, and 19 from birth until 11 months of age. At birth, 19 of the foals had a defect in the body wall at the umbilicus that was termed a 'palpable umbilical ring'. In 18 of them this defect disappeared within four days, but in the other the ring did not close and a hernial sac with abdominal contents was palpable. This foal was considered to be the only foal to have a truly congenital umbilical hernia. Twelve foals developed an umbilical hernia between five and eight weeks of age. The prevalence of umbilical hernias was much higher than in other studies, possibly owing to the prospective nature of the study.

Abdominal Muscles↗
PubMed2005

Case report: MR imaging features of endometriosis at the umbilicus.

The radiological features of extrapelvic endometriosis at the umbilicus with large ovarian endometriomas are described. In this patient, the umbilical lesion appears as hypointense on T(1) weighted and T(2) weighted MR images. The MR characteristics of endometriosis at the umbilicus are compared with those found within the pelvis.

Adult↗
PubMed2000

Transverse retubularized ileovesicostomy continent urinary diversion to the umbilicus.

The transverse retubularized ileovesicostomy is useful as a continent urinary diversion when the appendix is unusable or unavailable for an appendicovesicostomy continent urinary diversion. Eight patients (mean age 29 years) with difficulty catheterizing their native urethras underwent creation of a transverse retubularized ileovesicostomy continent urinary diversion to the umbilicus. Diagnoses included myelomeningocele (3), multiple sclerosis (1), and spinal cord injury (4). Concomitant procedures included ileocystoplasty, antegrade continence enema procedure, and pubovaginal sling. All patients were able to catheterize their ileovesicostomy conduit and stoma easily with a 14F catheter. Six patients were completely dry, and two patients needed to catheterize every 3 to 4 hours to prevent urinary leakage. Mean follow-up was 3 years. Experience with the transverse retubularized ileovesicostomy continent urinary diversion to the umbilicus has been favorable. When the Mitrofanoff appendicovesicostomy continent urinary diversion is not an option, the transverse retubularized ileovesicostomy has several advantages as a second choice.

Adolescent↗
PubMed2002

[The wet umbilicus: maybe not an umbilical granuloma?].

Three infants, 1 girl aged 10 months and 2 boys aged 2 and 4 months, presented with a discharging umbilicus directly or shortly after birth. Echography and cystography showed three different causes: a cystic remnant of the omphalomesenteric duct, a persistent urachus and a persistent omphalomesenteric duct. All were successfully managed surgically. The most common cause of a discharging umbilicus is an umbilical granuloma. This is usually treated by application of silver nitrate. In some patients, however, the discharge may not disappear or may contain urine or faecal material. These cases should be referred and echography performed. In case of an anomaly of the urachus or the omphalomesenteric duct, surgical exploration is mandatory. The lesion should be excised en bloc, together with a part of the bladder or the bowel.

Diagnosis, Differential↗
PubMed2003

Basal cell carcinoma of the umbilicus: a case report and literature review.

We report the case of a 43-year-old woman with basal cell carcinoma (BCC) of the umbilicus. Although BCC is a common skin tumor, only 2 cases of BCC arising within the umbilicus have been reported previously. Our review of the literature shows that truncal BCCs frequently develop in younger patients, often grow larger, and are associated with an increased risk for developing multiple nonmelanoma skin cancers. Therefore, we advocate a low threshold for performing biopsies on umbilical lesions that are atypical in appearance, course, or response to therapy.

Adult↗
PubMed1988

Bowen's disease of the umbilicus simulating psoriasis vulgaris.

Bowen's disease and other primary cutaneous malignancies are uncommon in patients with psoriasis. Primary malignancies of the umbilicus are also unusual. Plaques of psoriasis and Bowen's disease may appear morphologically similar, requiring examination of a biopsy specimen for definitive diagnosis. We report on a patient with psoriasis who experienced Bowen's disease of the umbilicus that was initially believed to be psoriasis.

Bowen's Disease↗
PubMed1984

The center of the umbilicus as the Veress needle's entry site for laparoscopy.

Transumbilical laparoscopy was performed on 217 patients for diagnostic purposes. The center of the umbilicus was chosen as the entry site for both the Veress needle and the trocar. Two years of follow-up on 92 patients, including 29 who carried full-term pregnancies, did not reveal any damage to the umbilicus or any hernia formation. Beyond cosmetic advantages, the procedure proved to be easier for creating a pneumoperitoneum. No false passage or obstructive bleeding occurred during the procedures.

Evaluation Studies as Topic↗
PubMed1994

[Primary carcinoid of the umbilicus. Description of the 1st case].

A 78-year old male came to our observation presenting and enlargement of bilateral inguinal lymph nodes and a tumor of the mesogastric abdominal wall. Three years before the patient had been operated on for a primary tumor of the umbilicus with concomitant longstanding diarrhea. No histological examination was performed at that time. We performed a lymph node biopsy which demonstrated carcinoid metastasis. We went on to perform radical resection of the abdominal wall, regional lymphadenectomy and right hemicolectomy for malignant villous adenoma of the right colon. The abdominal defect was repaired by using Goretex mesh. Cyclic adjuvant alpha-interferon therapy was continued for more than 1 year, followed by long term therapy with longastatin. Twenty months after the operation the patient is in good clinical conditions and disease-free. On the basis of literature review our case appears to be the first primary carcinoid of the umbilicus.

Abdominal Muscles↗
PubMed1994

Ultrasonography of the umbilicus in calves. Part 2: Ultrasonography, diagnosis and treatment of umbilical diseases.

In 80 calves presented with clinical signs of umbilical disease, the umbilicus was examined by palpation and by ultrasonography using a 5 Mhz or a 7.5 Mhz sector scanner. Diagnosis was confirmed during surgery or at post mortem examination. The various diseases of the intraabdominal umbilical structures found in these calves and the therapeutic procedures performed are described in detail by use of schematic representations, photographs of anatomical preparations, and ultrasonograms. In 29 calves with an enlarged extraabdominal umbilicus, ultrasonographic examination provided additional information to determine the choice of therapy, and it was particularly helpful in calves with irreducible hernias and with umbilical abscesses. In 51 calves with diseases of the intraabdominal umbilical structures, an exact description of the extent of the disease and of the involvement of other structures, as the liver and the urinary bladder, was made possible by ultrasonography. In calves with omphalitis, early recognition of the involvement of intraabdominal umbilical structures could be determined. Umbilical ultrasonography can be performed easily and is a very reliable and informative aid not only in the diagnosis of umbilical disease but also in determining the choice of therapy. Additionally, the owner can be informed in advance about the expense and the prognosis of the planned therapy.

Animals↗
PubMed1999

Wet umbilicus caused by pancreatic heterotopia in urachal remains.

Drainage from the umbilicus may be due to the presence of structures derived from the vitelline duct or urachus, granulomas, ectopic tissue, or poor hygienic practice. This paper discusses the case of a 6-month-old infant with a wet umbilicus caused by ectopic pancreatic tissue, in urachal remains. No similar cases have been found in the literature.

Choristoma↗