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Urachal Cyst
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
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For umbilical hernias, repair is generally delayed until the patient is at least 4 years of age, though some recommendations suggest 2 years as the lower age limit. — Meera Kotagal, Diagnosis and Management of Pediatric Umbilical Pathologies · 3:57
Umbilical Pathologies Bonus Episode
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This is a "snack size" bonus episode of 'Peds Umbilical Pathologies in Brief: Presentation, Workup, Diagnosis, Perioperative Considerations' video.For full video: https://www.youtube.com/watch?v=lmzIp8hXAG8 -Original Video Description- Umbi
podcast4:25 · Apr 2022
Differential diagnosis and management of pediatric umbilical pathologies
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Umbilical pathologies can present with a wide range of symptoms so here, we cover the basics of presentation, differentiation, diagnosis, surgical approach, and
podcast6:19 · Nov 2026
Diagnosis and Management of Pediatric Umbilical Pathologies
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Dr. Meera Kotagal, Dr. Rae Hanke, and Dr. Gillian Goddard come together to provide you the essential on diagnosis and management of pediatric umbilical hernias.
podcast6:44 · Nov 2026
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Umbilical Pathologies Bonus Episode
Umbilical hernia is the most common cause of umbilical bulge in infants.
clinicalMeera Kotagal0:34 ↗
The differential diagnosis of umbilical bulge includes umbilical hernia, urachal cyst, patent omphalomesenteric duct, umbilical granuloma, umbilical polyp, and omphalitis (when significant erythema is present).
clinicalMeera Kotagal0:34 ↗
Urine draining from the umbilicus is associated with a patent urachus.
clinicalMeera Kotagal1:00 ↗
Succus draining from the umbilicus suggests a patent omphalomesenteric duct.
clinicalMeera Kotagal1:00 ↗
When ultrasound shows patent urachus or patent omphalomesenteric duct, the next step is usually operative exploration.
Host summaryEllen Encisco summarizes what Dr. Mira Kotigal said — not the host's own clinical position1:25 ↗
An umbilical polyp is a small remnant of the omphalomesenteric duct extending from the umbilicus that can be excised.
clinicalMeera Kotagal1:56 ↗
An umbilical granuloma is granulation tissue or asymptomatic pink tissue at the base of the umbilicus, often seen in very small infants shortly after umbilical cord separation, treated with silver nitrate.
clinicalMeera Kotagal1:56 ↗
On physical exam, an umbilical polyp has a stalk and can be moved around more freely, whereas granulomatous tissue is more stuck on at the base of the belly button.
Host summaryEllen Encisco summarizes what Dr. Mira Kotigal said — not the host's own clinical position2:16 ↗
The primary risk factor for umbilical hernias is prematurity.
epidemiologicalMeera Kotagal2:42 ↗
African-American infants are 8 times more likely to have an umbilical hernia compared to Caucasians.
epidemiologicalMeera Kotagal2:42 ↗
For umbilical hernias, clinicians generally wait until the patient is at least 4 years of age before surgical repair.
Host summaryRod Gerardo summarizes what Dr. Mira Kotigal said — not the host's own clinical position2:56 ↗
85% of infant umbilical hernias will close on their own.
epidemiologicalMeera Kotagal3:09 ↗
Small umbilical hernia defects are more likely to close spontaneously compared to larger defects (those over 1 to 1.5 centimeters).
clinicalMeera Kotagal3:09 ↗
Routine pediatric umbilical hernias are repaired as an outpatient procedure.
clinicalMeera Kotagal3:28 ↗
Pediatric umbilical hernia repair does not use mesh, unlike adult repairs.
clinicalMeera Kotagal3:28 ↗
During pediatric umbilical hernia repair, it is important to close normal fascia to normal fascia, not hernia sac to hernia sac.
clinicalMeera Kotagal3:28 ↗
Differential diagnosis and management of pediatric umbilical pathologies
The differential diagnosis for a pediatric umbilical bulge includes umbilical hernia (most common), urachal cyst, patent omphalomesenteric duct, umbilical granuloma, umbilical polyp, and omphalitis if significant erythema is present.
clinicalMeera Kotagal0:49 ↗
Urine draining from the umbilicus is associated with a patent urachus.
clinicalMeera Kotagal1:17 ↗
Succus draining from the umbilicus suggests a patent omphalomesenteric duct.
clinicalMeera Kotagal1:22 ↗
When ultrasound shows a urachal remnant or omphalomesenteric duct but cannot distinguish between them, the next step is operative exploration.
Host summaryEllen Encisco summarizes what Dr. Mira Kotigal said — not the host's own clinical position1:37 ↗
For excision of urachal or omphalomesenteric remnants, a curvilinear infra-umbilical incision is made, attachments from umbilicus to bladder or intestine are identified and tracked down, then divided.
clinicalMeera Kotagal1:46 ↗
For urachal remnant excision, the remnant must be tracked all the way down to the bladder, and the bladder is repaired in two layers.
Host summaryEllen Encisco summarizes what Dr. Mira Kotigal said — not the host's own clinical position2:00 ↗
An umbilical polyp is a small remnant of the omphalomesenteric duct extending from the umbilicus that can be excised by tying it off and ligating it in clinic, then dividing it or letting it fall off over time.
clinicalMeera Kotagal2:15 ↗
An umbilical granuloma is granulation tissue or asymptomatic pink tissue at the base of the umbilicus, often seen in very small infants shortly after cord separation, and is treated with silver nitrate.
clinicalMeera Kotagal2:29 ↗
On physical exam, an umbilical polyp has a stalk and can be moved around more freely, whereas granulomatous tissue is more stuck on at the base of the belly button.
clinicalMeera Kotagal2:49 ↗
The primary risk factor for umbilical hernias is prematurity.
epidemiologicalMeera Kotagal3:04 ↗
African-American infants are 8 times more likely to have an umbilical hernia compared to Caucasians.
epidemiologicalMeera Kotagal3:12 ↗
For umbilical hernias, repair is usually deferred until the patient is at least 4 years of age.
Host summaryRod Gerardo summarizes what Dr. Mira Kotigal said — not the host's own clinical position3:23 ↗
85% of infant umbilical hernias will close on their own.
epidemiologicalMeera Kotagal3:30 ↗
Small umbilical hernia defects are more likely to close spontaneously compared to larger defects (those over 1 to 1.5 cm).
clinicalMeera Kotagal3:34 ↗
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