Big Protruding Belly Button Differential Diagnosis Table

Big Protruding Belly Button Differential Diagnosis Table:

A belly button is present in the lower abdomen as a remnant of the umbilical cord. The umbilical cord serves as a source of nutrition for the growing fetus. After birth, the umbilical cord is no longer needed and is cut off by the doctor. Some portion of the umbilical cord remains after cutting and sheds in about 2 weeks. The aftermath of this produces the belly button, formally called the navel.
Some people can have their belly buttons outwards, and some have them inwards. In rare instances, with a diseased state, some people have a protruding belly button. This is present mostly in infants and can occur due to a variety of reasons. The most common causes are developmental malformation, hernia, and infection.

How To Recognize Which Disease Is Causing The Big Protruding Belly Button

How to Recognize if Umbilical Hernia is Causing The Painless Oval Swelling or Mass

Hernias develop as a result of weakness in the muscle wall and push the inside body contents outside. An umbilical hernia develops when the abdominal wall develops a weakness, and the intestinal content protrudes outside of the navel. It is a common occurrence in children but can occur in adulthood too.
Symptoms and signs of umbilical hernia include a visible bulge near the navel. It increases in size upon laughing, coughing, and breathing deeply. When the patient lies down, the bulge becomes smaller in size or disappears completely. The bulge associated with an umbilical hernia is usually reducible, which means it can go back if pressure is applied.

How to Recognize if Congenital Umbilical Granuloma is Causing The Painless Oval Swelling or Mass

Congenital umbilical granuloma, an abnormality present from birth, is the most common cause of a mass projecting out of the belly button. This affects mostly infants. When the umbilical cord is separated from the body, granulation tissue forms as a normal healing process. This tissue sometimes develops abnormally into a granuloma.
The common signs include a pink, moist, soft, or irregular surface; pedunculated; and a few mm to cm wide mass protruding outside the navel. It is usually pain-free in children. In rare instances, it can affect adults too, and in that case, it is painful.

How to Recognize if Omphalitis is Causing The Painless Oval Swelling or Mass

The remaining umbilical stump can sometimes become colonized by bacteria and can produce an infection. Omphalitis is an infection of the umbilicus or the area surrounding it in the newborn. It is uncommon in adults.
The common signs include a distressed baby with a fever, irritability, lethargy, fatigue, and persistent crying. The area or skin surrounding the navel may be red, warm, tender, and have pus discharge. Sometimes bleeding can also be present.

How to Recognize if Omphalocele is Causing The Painless Oval Swelling or Mass

During the development of the intestine during pregnancy, the intestines protrude outside and go into the umbilical cord. As the development proceeds, they eventually go back inside. If this fails to occur, an omphalocele develops.
Omphalocele is a sac-like projection outside the baby’s abdomen in which all the internal organs are visible through a transparent surface. There are usually no associated symptoms as it is detected during routine ultrasounds of the mother during pregnancy. If not, it is detectable soon after birth, and care can be taken then.

How to Recognize if Gastroschisis is Causing The Painless Oval Swelling or Mass

Gastroschisis is another condition present at birth, like omphalocele. This is due to a developmental defect in the abdominal wall, resulting in a few cm hole in it, and the inner organs, primarily the intestine, project outside. It is similar to omphalocele; the only difference is the absence of a membrane covering the protruded organs in gastroschisis.
There are usually no symptoms other than visibility on the ultrasound. During pregnancy, it is detectable on ultrasound, and if it goes unnoticed for any reason, it is detected straight after birth.

How to Recognize if Incarcerated Umbilical Hernia is Causing The Painless Oval Swelling or Mass

An umbilical hernia is a bulge created by the protrusion of internal organs of the lower intestinal region due to weakness in the abdominal muscle wall. Common signs and symptoms of umbilical hernia include a visible bulge in the lower abdominal region. This is sometimes the only symptom among individuals. In rare instances, the hernia becomes constricted, and this is known as the incarceration of an umbilical hernia.
Signs of incarceration are pain, vomiting, nausea, and discoloration. The bulge is usually irreducible, which means it cannot go back by applying pressure. On palpation, the area is tender. Also, the patient might have hypotension and tachycardia.

Common Red Flags With The Big Protruding Belly Button

A big protruding belly button is usually present in infants, as compared to adults. Although the incidence of omphalocele and gastroschisis is low, when present, it causes psychological trauma to the parents and physical trauma to the infants. There is an increased incidence of preterm birth, fetal death, and feeding difficulty in these infants. These infants have chances of breathing difficulty, heart defects, and other developmental defects.
If an umbilical hernia is present in infants, it rarely results in any complications and can be corrected spontaneously without long-term effects. In adults, if an umbilical hernia is present, there is a chance of strangulation or incarceration of the hernia. In such cases, there is a chance of blood supply disruption to the strangulated segment, and it can result in ischemia and necrosis of the segment. It can further lead to sepsis, which can be life-threatening.