Umbilical fossa moist and smelly
Introduction
Introduction The oozing of the umbilical fossa is one of the clinical symptoms of umbilical inflammation. Omphalitis is a bacterial infection of the umbilical stump.
Cause
Cause
(1) Causes of the disease
1. Pathogenic bacteria are the most common pathogens of staphylococcus, followed by Escherichia coli and hemolytic streptococcus. According to reports, the main pathogens of socially acquired infections are Gram-positive cocci (67.2%); while in hospital-acquired infections, Gram-negative bacilli are the main pathogens (56.8%).
2. Causes of infection
(1) Acute navel inflammation:
1 neonatal umbilical corditis: the main causes of umbilical cord infection in newborns are: contamination after umbilical cord ligation after birth or dressing contaminated by feces and urine before umbilical cord detachment; premature rupture of amniotic membrane, contamination of umbilical cord before birth; umbilical cord is produced during childbirth Bacterial contamination in the tract; contaminated by urinary tract or yolk sputum effluent; infection secondary to umbilical cord or umbilical sinus.
2 adult umbilical corditis: the umbilical fossa is deep and the skin on the underside is wrinkled. The dirt and sebum remain, which is not easy to be cleaned locally, or inadvertently scratched during descaling, causing bacteria to invade and cause infection.
(2) Chronic umbilical inflammation: acute umbilical inflammation is not cured, prolonged to chronic umbilical inflammation and umbilical granuloma; umbilical cord premature detachment leaves unhealed wounds; long-term chronic stimulation of foreign bodies (such as talcum powder) in umbilical fossa can cause Umbilical inflammation is delayed and forms umbilical granuloma.
(two) pathogenesis
After the pathogen invades the umbilicus, the early stage is limited to local infection. If the inflammation is not controlled, the range of inflammation is enlarged, and the abdominal wall cellulitis is present. The spread of infection along the lymph can cause widespread infection of the upper and lower abdominal wall and even the lower chest. Umbilical abscess may form after the infection is limited. If it is deep, it may cause peritonitis. Neonatal infection can still enter the blood through the umbilical cord, vein, and portal vein inflammation, portal vein embolism or sepsis. If the thrombus extends to the portal vein, it can lead to portal vein obstruction, resulting in extrahepatic portal hypertension. If the local wound healing is poor after the umbilical cord is broken, and the small granuloma remains, there is often secretion, which is chronic umbilical inflammation.
Examine
an examination
Related inspection
Physical examination of skin fungus microscopic examination of skin diseases
Neonatal umbilical inflammation: The initial symptom is that the wound is delayed and there is an overflow after the umbilical cord falls off. Sometimes there is redness and swelling of the umbilical cord, and there is a small amount of mucus or purulent secretion in the small granulation surface or umbilical stump in the umbilicus. In severe cases, there may be symptoms of cellulitis such as redness, swelling, heat, and pain. When the infection is more serious, it can be seen that the umbilical cord is obviously red and swollen and hard, and there are more purulent secretions. The umbilical cord is lightly pressed, and the pus flows out from the umbilicus and has an odor.
Generally, the systemic symptoms are mild. If the infection spreads to the peritoneum leading to peritonitis, patients often have different degrees of fever and increased white blood cells. If sepsis is caused by the spread of blood vessels, irritability, paleness, refusal of milk, difficulty in breathing, and large splenomegaly may occur.
Diagnosis
Differential diagnosis
1. The umbilical sinus is caused by the umbilical end of the yolk tube.
2. Umbilical intestinal fistula (the yolk tube is not closed) A bright red mucosa with a rounded protrusion is visible in the umbilicus. There is a mouth in the middle, there is a odor discharge or liquid feces, oral charcoal or a contrast agent is injected into the umbilicus. X-ray examination can confirm the diagnosis. Need surgery.
3. Umbilical urethral fistula (ursal ureteral obstruction) The umbilicus often has clear liquid outflow, local injection of contrast agent can enter the bladder or bladder retrograde angiography to reach the skin, injecting methylene blue to the umbilicus to discharge blue urine. Need surgery.
