Umbilical Granuloma vs. Patent Omphalomesenteric (Vitelline) Duct
Right picture: The diagnosis is a patent omphalomesenteric duct with discharge of bilious intestinal fluid due to a communication between navel and small intestine. Left picture: In this case a relatively large granuloma of the umbilicus (navel granuloma) is present. After dropping off of the navel stump which occurs about 1-3 weeks after birth, some granulation tissue with a diameter of 1-10 millimeters may appear on its base due to a delay in shrinkage and epithelization of the navel plate. Navel granulomas have some significance for the parents if they are wetting or bleeding, are large and/or last longer than a few days. In these cases epithelization occurs following repeated cauterization with silver nitrate. For the physician, the significance of navel granuloma are the differential diagnoses of omphalitis or omphalomesenteric or urachal duct remnants (e.g. patent Vitelline duct). In addition to the navel granuloma, an emerging umbilical hernia is present. (Cutis navel; Umbilical granuloma www.nurse.cmu.ac.th)
Right picture: Following dropping off of the navel stump a reddish centre of the navel becomes prominent in this newborn. Left picture: Newborn with a large navel and with reddish tissue on its top. Following dropping off of the navel stump, instead of epithelization a fleshy tissue is developing. Right picture: In the fleshy tissue a yellowish fluid is secreted. Left picture: The navel is wetting and/or slightly bleeding.