Lauren Kinneman DO, Inova Fairfax Medical Center

The Case
A 20do M is referred from his PCP with an abnormal umbilical stump.

Here’s How You Answered Our Questions:

Discussion:
The discussion boiled down to the amount of uncertainty individual providers were willing to tolerate when seeing an infant in the ED. While most providers seemed to agree that there was nothing “dangerous” about this baby’s presentation, the lack of a definite diagnosis caused almost all respondents to consult surgery. Eiman’s comment expertly summarizes the differential for this patient.

Denouement:
The case was discussed with the surgeon on call, who did not recommend any emergent intervention, including any attempt at cautery. After discussing the case with the patient’s pediatrician and ensuring timely follow up, the provider discharged the patient home. He has since been seen by both her pediatrician and a pediatric surgeon, however the lesion regressed prior to any surgical intervention, and the patient now has a prominent “outie” without any visible granulation tissue.

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