Umbilical abscess as a rare cause of abdominal pain: A case report

Abstract

Rationale: Abdominal pain is a common complaint with a broad differential diagnosis, including both intra-abdominal and abdominal wall pathologies. While visceral causes are frequently considered, abdominal wall conditions are often overlooked, leading to diagnostic delays. Among them, umbilical abscesses are rare but require distinction from urachal abscesses due to differences in management.

Patient’s concern: A 46-year-old woman presented with a one-week history of periumbilical pain unresponsive to analgesics.

Diagnosis: Physical examination revealed localized tenderness and a positive Carnett’s sign. Computed tomographic images identified an umbilical abscess without evidence of urachal remnants, ruling out a urachal abscess.

Interventions: The patient underwent abscess drainage and received cefalexin (1500 mg/day) for 28 days.

Outcomes: The abscess resolved completely without recurrence.

Lessons: Umbilical abscesses are rare and may be mistaken for urachal abscesses. A thorough clinical evaluation, including Carnett’s sign and imaging studies, is crucial for accurate diagnosis. Prompt differentiation facilitates appropriate management and prevents unnecessary interventions.

Keywords

Umbilical abscess / Urachal abscess / Abdominal pain / Carnett’s sign

Conflict of interest statement

The author has no conflicts of interest.

Funding

This study received no extramural funding.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

[1] van Assen T, de Jager-Kievit JW, Scheltinga MR, Roumen RM. Chronic abdominal wall pain misdiagnosed as functional abdominal pain. J Am Board Fam Med 2013; 26(6):738-744.

[2] Habl M, Mokhtar AR, Makharita M, Anwar R. Management of chronic abdominal wall pain: A one-year study. Med J Viral Hepat 2020; 5(1):33-40.

[3] Shian B, Larson ST. Abdominal wall pain: Clinical evaluation, differential diagnosis, and treatment. Am Fam Physician 2018; 98(7):429-436.

[4] Suleiman S, Johnston DE. The abdominal wall: An overlooked source of pain. Am Fam Physician 2001; 64(3):431-438.

[5] Tawk A, Abdallah A, Meouchy P, Salameh J, Khoury S, Kyriakos M, et al. Omphalitis with umbilical abscess in an adult with a urachal remnant. Case Rep Gastroenterol 2021; 15(3):966-971.

[6] García García L, Ballesta B, Rodríguez Talavera J, Morales Orribo N, Carrión A. Urachal pathology: Review of cases. Urol Int 2022; 106(2):195-198.

[7] Almas T, Khan MK, Fatima M, Nadeem F, Murad MF. Urachal sinus complicated by an umbilical abscess. Cureus 2020; 12(8):e9527.

[8] Torabi H, Shirini K, Ghaffari R. Rare case of umbilical urachal sinus mimicking infected umbilical abscess: A case report. Clin Case Rep 2022; 10(3):e05598.

[9] Painter K, Anand S, Philip K. Omphalitis. In: StatPearlsPublishing, Florida2022. [Online] Available from:

[10] Kasiakou SK, Rafailidis PI, Rosmarakis ES, Falagas ME. Recurrent omphalitis in adults. Scand J Gastroenterol 2004; 39(10):1021-1024.