Chang Yu-Tang, Lin Jan-You
Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, and Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2007 Feb;23(2):80-3. doi: 10.1016/S1607-551X(09)70379-1.
Redness of the umbilicus is usually considered to be a reliable sign of underlying gangrenous bowel or peritonitis in tiny infants but seldom among non-neonatal patients. We report a 19-month-old girl with final diagnosis of typhoid colonic perforation who initially presented with abdominal distention and umbilical erythema on arrival at our emergency department. The redness of umbilicus diminished gradually after laparotomy. Thin abdominal wall, severe intra-abdominal soiling, and polymicrobial infection accounted for the inflammatory process spreading to the skin of the umbilicus. Because of its rarity beyond the neonatal period, prompt diagnosis depends on maintaining a high index of suspicion when the abdomen is distended and suddenly tender to palpation.
脐部发红通常被认为是小婴儿潜在坏疽性肠病或腹膜炎的可靠体征，但在非新生儿患者中很少见。我们报告一名19个月大的女孩，最终诊断为伤寒性结肠穿孔，她最初因腹胀和脐部红斑就诊于我院急诊科。剖腹手术后脐部发红逐渐减轻。腹壁薄、严重的腹腔内污染和混合感染导致炎症扩散至脐部皮肤。由于新生儿期以外这种情况罕见，当腹部膨胀且触诊突然压痛时，及时诊断依赖于保持高度的怀疑指数。
