title: Red umbilicus as a clinical manifestation in a 19-month-old girl with typhoid colonic perforation.
abstract: 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.
authors.affiliation: 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.
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Chang
authors.forename: Jan-You
authors.initials: JY
authors.lastname: Lin
mesh_terms: D003108:Colonic Diseases / Q000150:complications*; D004890:Erythema / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000150:complications*; D014435:Typhoid Fever / Q000150:complications*; D014472:Umbilicus / Q000473:pathology*