A bleeding umbilical mass

Question A 57-year-old man with a 3-year history of diabetes was referred to our surgical department for evaluation of a bleeding lesion in the umbilicus (figure 1). The patient reported having been evaluated 4 months before and scheduled for umbilical hernia repair. At presentation, the patient reported vague back pain, whereas he denied fever, nausea or vomiting. Upon physical examination, the abdomen was soft, with normal bowel sounds. There was an obvious, ulcerated umbilical mass measuring about 4 cm in diameter. It was hard in consistency, with serosanguinous discharge. The surrounding skin did not appear red, warm or swollen. Laboratory tests revealed a mild anaemia (10.2 g/dL). A contrast-enhanced abdominal CT was obtained (figure 2). See page 1014 for answer See page 913 for question Answer CT depicted a large, irregular, solid mass involving the umbilicus without direct spreading to the surrounding peritoneal tissues (
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research