Look the shape and position of umbilicus.
Describe the normal position of umbilicus :

  • Umbilicus lies more or less in the midway between xiphlsternum and symphysis pubis
  • Normally It is inverted and slightly retracted.
  • The slit is circular, le. neither horizontal nor vertical (the slit is transverse in ascites, and vertical in the presence of ovarian cyst).

Causes of inverted and everted umbilicus :
Everted—Seen in any condition giving rise to increased intra-abdominal tension like ovarian
cyst, pregnancy, hydramnios. severe gaseous distension etc.
Inverted—Normally in health and in obesity.
Slit of umbilicus
Vertical slit is noted in – Ovarian tumor – Horizontal slit in  – Ascites
Omphalolith – presence of inspissated desquamated epithelium and other debris

  • Umbilicus is buried in fat in obesity
  • Increase in distance between umbilicus and xiphisternum  noted in upper abdominal mass and ascites
  • Increase in distance between umbilicus and symphysis pubis observed in Lower abdominal mass
  • Shift of umbilicus to opposite side occur to due to masses of lumbar and iliac fossa
  • Metastatic deposit in the umbilicus is noted in Sister Joseph nodule.

copyright @ Dr. Ramjee

Examination of umbilicus

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