Presentation
Two-week history of umbilical swelling, low-grade fever, raised CRP and WCC. On examination, very tender, hard lump and induration around the umbilicus, possibly umbilical hernia. Urgent CTAP to investigate? umbilical hernia? strangulation.
Patient Data
Significant acute inflammation is noted at the umbilical region with soft tissue thickening - no intra-abdominal communication.
Adjacent anterior abdominal wall inflammation - no evidence of umbilical hernia or strangulation.
The intra-abdominal organs appear normal - no free fluid or lymphadenopathy.
Case Discussion
Differential diagnoses on imaging include a pilonidal sinus, umbilical hernia, folliculitis, and carbuncle.
The patient underwent excision of a severely infected umbilicus and recovered well postoperatively.
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