OMD sinus
An OMD sinus should be suspected when mucus discharge is noted in the presence of an umbilical polyp or granuloma.
Patent OMD may be identified early in the neonatal period due to persistent feculent discharge.However, cysts and sinus tract may require additional evaluation, including ultrasonography and fistulography.
Management involves surgical exploration to exclude associated OMD or urachal remnants and excision of the duct.
Umbilical cysts
Umbilical cysts may present as a firm, erythematous, cystic swelling at the umbilicus but are typically asymptomatic.
In some cases, they may present with bowel obstruction or infection.
Funisitis
Funisitis is inflammation of the connective tissue of the umbilical cord that occurs with chorioamnionitis. It involves only the external cord surface and Wharton's jelly. It has no involvement of the vessels.
It does not involve the umbilical stump, which would be seen in omphalitis.
Necrotizing funisitis occurs with long-standing infection and is characterized by inflammatory debris and calcification of umbilical cord tissues.
Infants with funisitis can be born healthy, but should be treated with broad-spectrum antibiotics (similar to the regimen used for omphalitis) for a minimum of seven days of therapy.
