What's the matter with the small fleshy lump in the belly button

If you observe carefully, you will find that there is sometimes some dirt in the belly button. This is automatically secreted by the belly button during metabolism. However, some people find that there is a small lump of flesh in their belly button, which feels like muscle to the touch. This is most likely caused by inflammation, which is commonly known as omphalitis. If the belly button is inflamed, it must be treated promptly. So, what is the matter with the small lump of flesh in the belly button?

Omphalitis is a bacterial infection of the umbilical stump. Depending on the age of onset, omphalitis can be divided into adult omphalitis and neonatal omphalitis, and divided into acute omphalitis and chronic omphalitis. Acute omphalitis is an acute cellulitis of the periumbilical tissue. If the infection progresses, it may be complicated by abdominal wall cellulitis and may also develop into a periumbilical abscess, and there is a risk of complications such as peritonitis and sepsis. The pathogenic bacteria include Staphylococcus aureus, etc. Chronic omphalitis is a chronic inflammation of the umbilicus caused by irregular and prolonged treatment of acute omphalitis, or by unhealed wounds and local stimulation from foreign bodies left after the umbilical cord falls off in newborns.

Causes

1. Pathogenic bacteria

Staphylococcus aureus is the most common, followed by Escherichia coli, Pseudomonas aeruginosa and hemolytic Streptococcus. It is reported that the main pathogens of community-acquired infections are Gram-positive cocci (67.2%), while in cases of hospital-acquired infections, Gram-negative bacilli are the main pathogens (56.8%).

2. Causes of infection

(1) Acute omphalitis ① The main causes of neonatal umbilical cord infection due to omphalitis are contamination during ligation of the umbilical cord after birth or contamination of the dressing with feces or urine before and after the umbilical cord falls off; premature rupture of the amniotic membrane and contamination of the umbilical cord before birth; contamination of the umbilical cord by bacteria in the birth canal during delivery; contamination by the outflow of urachal fistula or vitelline duct fistula; secondary infection of the umbilical cord or umbilical sinus. ② In adults with omphalitis, the umbilical fossa is deep and the skin on the bottom is wrinkled, where dirt and sebum are retained, making it difficult to clean the area. If the area is accidentally scratched during degreasing, bacteria may invade and cause infection.

(2) Chronic omphalitis: Acute omphalitis is not cured and may develop into chronic omphalitis and umbilical granuloma; premature detachment of the umbilical cord leaves an unhealed wound; long-term chronic stimulation of foreign matter (such as talcum powder) in the umbilical fossa may cause omphalitis to persist and form umbilical granuloma.

Clinical manifestations

1. Acute omphalitis

(1) The initial symptoms of neonatal omphalitis are delayed wound healing and discharge after the umbilical cord falls off, sometimes redness and swelling of the umbilical ring, small granulation surfaces in the umbilical pit, or a small amount of mucus or purulent secretions at the umbilical stump. In severe cases, there may be symptoms of cellulitis such as redness, swelling, heat, and pain. When the infection is more serious, the area around the navel will be obviously red, swollen and hardened, with a lot of purulent secretions. If you press lightly around the navel, pus will flow out from the navel with a foul odor. Generally, systemic symptoms are mild. If the infection spreads to the adjacent peritoneum and causes peritonitis, patients often have varying degrees of fever and increased white blood cell count. If sepsis is caused by blood vessel spread, symptoms such as irritability, pale complexion, refusal to drink milk, difficulty breathing, and hepatosplenomegaly may appear.

(2) The acute stage of omphalitis in adults is characterized by pain, congestion, and edema in the umbilical fossa or around the umbilicus, often with a foul-smelling serous discharge. Physical examination may reveal moistness in the umbilical fossa, swelling and tenderness around the umbilicus. In severe cases, there may be pus accumulation in the umbilical fossa accompanied by fever, and there may be enlarged lymph nodes in the groin. Occasionally, it may spread to the area around the umbilicus and cause deep infection, cellulitis, and systemic symptoms.

2. Chronic omphalitis

The umbilical fossa is moist and swollen, with foul-smelling exudate that may be purulent or mixed with blood. Because the secretions irritate the surrounding skin, it can cause eczema-like changes or even erosion. Adults or older children report feeling itchy and often scratching the navel with their hands. Physical examination revealed hyperplasia of granulation tissue in the umbilical fossa, which was dark red in color, with a raised surface, no mucosal covering, and bleeding upon touch. Most of the diseases last for a long time and are difficult to heal.