Umbilical discharge in neonates: A case-based management protocol performed from a different perspective

Abstract

Aim: This study aimed to retrospectively investigate causes of umbilical discharge (UD), its clinical course, treatment modalities and follow-up in infants with UD complaints in a major teaching hospital in Turkey. Material and Method: Infants with an UD complaint who were referred to our clinic by a pediatrician or a family physician from January 2013 to June 2014 were investigated. Results: The study included 291 infants between the ages of 3 and 114 days. Of these infants, 194 (67%) had an umbilical granuloma, 83 (28.3%) had an umbilical polyp, and 14 (4.8%) had omphalitis. Among 14 infants with omphalitis who were treated with topical antibiotics, six infants had refractory or recurrent discharge and ultrasonography (US) was performed which revealed a 1-3 mm sized cystic appearance with no connection to the peritoneum or other tissues. These infants received systemic antibiotics in addition to topical antibiotics. During the follow-up period, cystic appearance was not present in US in three of these six patients and in the remaining three patients who did not present for follow-up we learned via phone calls that their complaints had not recurred. Discussion: Cauterization using a silver nitrate pencil was sufficient in the umbilical granuloma. Ligating, excising and cauterizing the base of the lesions was sufficient in an umbilical polyp. In cases with persistent or recurrent UD, high-resolution US should be primarily performed, which may direct the subsequent management.