Umbilical Metastases

Introduction When someone looks at anything, it's nothing or a many-thing The eyes of the beholder make it trivial or great Solomon without a flicker called it "globlet full of liquor" And for the umbilicus that is very high estate. —Bean1 Occasionally, abnormalities of the umbilicus supply important clues to the diagnosis of internal disease. Periumbilical ecchymosis may signal intra-abdominal or retroperitoneal hemorrhage.2Distended veins encircling and radiating from the navel suggest cirrhosis of the liver.3A prominent paraumbilical vein(s) over which a continuous murmur and thrill can be demonstrated is another manifestation of portal hypertension.4The discharge of pus from the navel sometimes heralds pelvic or abdominal abscesses,5while the seepage of bloody material from this structure may occur as a consequence of umbilical endometriosis.6In a few instances the "belly button" serves as an exit for urine,7ascitic fluid,8,9feces, gallstones, round worms, Echinococcus daughter cysts, foreign