Omphalolith presented with peritonitis: a case report
© licensee BioMed Central Ltd. 2009
Received: 6 June 2009
Accepted: 25 June 2009
Published: 5 August 2009
Omphalolith is a hard, smooth, almost black bolus found in the umbilicus, resembling a malignant melanoma. It is often accompanied by seborrhea which may lead to abscess formation. It may be related to poor hygiene. Patient is usually complaining of umbilical discharge and pain. This report describes a rare case of omphalolith (umbilical stone) induced peritonitis, in a patient who presented as acute appendicitis. In our case the two umbilical stones found their way to the peritoneal cavity and induced peritonitis.
Omphalolith is presented with a firm, black umbilical mass. It is easily removed with a warmed otic glycerin preparation. Histologic examination showed that it contained laminated keratin, amorphous material resembling sebum, numerous terminal hairs, and scattered collections of bacteria. Moderate amounts of argentaffin staining material were detected throughout the specimen, and the black color of the lesion was probably due to melanin and oxidized lipids, much like an open comedone. The mass is appropriately called an omphalokeratolith . Differential diagnosis of the omphalic stone includes the so called umbilical cholesteatoma, an accumulation of crumbling, fetid masses in the umbilicus . Omphalolith often accompanied by seborrhea which may lead to abscess formation . Omphalolith is usually associated with bad hygiene and it could be detected by abdominal plain x-ray and abdominal CT scan. It can be removed by squeezing the stone from the umbilical foramen or through adequate opening of umbilical foramen under local anesthesia to the periumbilical area .
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
- Friedman SJ, Liles WJ: Omphalokeratolith. Cutis. 1987, 40: 144-146.PubMedGoogle Scholar
- Ehring F: Omphalolith. Hautarzt. 1979, 30: 494-496.PubMedGoogle Scholar
- Imaizumi T: A case of omphalith in a patient with seborrheic keratosis of the umbilicus. Ann dermatol Venereol. 1989, 116: 27-28.PubMedGoogle Scholar
- Tsukasa H, Hidetsugu M, Koji K, Eiji T, Masayuki O: A case of a huge umbilical stone with difficulty in removal. Journal of Japan Surgical Association. 2003, 64: 1511-1514.Google Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.