A woman with recurrent umbilical bleeding: a case report

Area of Science:

• Gastroenterology
• General Surgery

Background:

• Umbilical discharge in adults is uncommon, presenting a wide differential diagnosis.
• The umbilicus can be affected by congenital anomalies, acquired pathologies like hernias, malignancy, or endometriosis.

Observation:

• A 40-year-old woman presented with spontaneous umbilical bleeding, periumbilical pain, nausea, and emesis.
• Physical examination revealed no visible skin abnormalities, but palpation yielded serosanguineous fluid.
• A prior similar episode occurred five years earlier without a clear cause.

Findings:

• Laboratory tests showed mildly elevated C-reactive protein.
• Computed tomography imaging identified an umbilical hernia containing fat with evidence of fat necrosis.
• Surgical resection of the umbilicus was performed.

Implications:

• Umbilical hernia with fat necrosis is a rare cause of adult umbilical discharge and bleeding.
• Other considerations for adult umbilical discharge include embryonal remnants, omphalitis, and metastasis.
• Computed tomography is recommended for diagnosing umbilical hernias and embryonal anomalies when the cause is not clinically apparent.