Kwanseop Lee, Presenter: Nothing to Disclose

Hyeon Hwan Jo, Abstract Co-Author: Nothing to Disclose

Eui-Young Jeon MD, Abstract Co-Author: Nothing to Disclose

Kyoonsoon Jung, Abstract Co-Author: Nothing to Disclose

Jin Hee Moon MD, Abstract Co-Author: Nothing to Disclose

Sang-Geon Park, Abstract Co-Author: Nothing to Disclose

Omphalitis is predominantly a disease of the neonates. It remains a common cause of neonatal mortality in less developed area and can cause serious complications. Nevertheless the imaging findings are seldom known in the radiologic examination. The purpose of this study is to evaluate the sonographic findings of omphalitis and usefulness of sonogrphy in the evaluation of underlying causes of omphalitis.  

A computerized search of our institutional data revealed 54 patients with omphalitis on ultrasonography from March 2006 to February 2012. We reviewed retrospectively the imaging findings and underlying causes of omphalitis using ultrasonography.

Twenty-seven patients (50.0%) were male and 27 were female. 51 patients were newborn infants (94.4%) and remained children (5.6%) were less than 2-months-old. 49 patients (90.7%) revealed hypoechoic change of umbilicus. Others showed isoechoic (3.7%), hyperechoic (1.8%), or heterogeneous echoic (3.7%) changes. In all 54 patients, enlarged ulbilicus on gray scale image with increased vascularity was noted on color Doppler sonography. Using sonography, we could assess the causes omphalitis. 50 patients (92.6%) were suggested as urachal remnant inflammation because there was tubular hypoechoic structure between the inflamed umbilicus and anterosuperior portion of the bladder. One neonate was suggested as omphalomesenteric duct remnant (1.8%). And the remaining 3 (5.6%) howed no underlying causes, suggesting omphalitis only. Three children underwent surgery and proved urachal remnant in two, omphalomesenteric duct anomaly in one. Remaining 51 children were treated through conservative management with complete improvement on follow up US.  

Omphalitis has characteristic sonographic findings. Most of the children revealed underlying congenital anomalies including urachal remant inflammation or omphalomesenteric anomaly. Most of the urachal remnant inflammation was treated successfully by conservative management. 

Sonographic evaluation of the omphalitis will reveal causes of underlying anomaly and could guide the proper treatment.

Lee, K, Jo, H, Jeon, E, Jung, K, Moon, J, Park, S, Omphalitis in Neonates and Infants: Imaging Findings and Assessment of Underlying Causes Using Sonography.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12036814.html