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Case report
Complexities of an uncomplicated symptom: two cases of umbilical discharge
  1. Nitin Agarwal1,
  2. Nikhil Gupta2,
  3. Manu Vats2 and
  4. Mradul Garg3
  1. 1Department of Surgery and Renal Transplant, ABVIMS and Dr RML Hospital, New Delhi, Delhi, India
  2. 2Department of Surgery, ABVIMS and Dr RML Hospital, New Delhi, Delhi, India
  3. 3Minimal Invasive, GI and Bariatric Surgery, Metro Heart Institute with Multispeciality, Faridabad, Haryana, India
  1. Correspondence to Dr Mradul Garg; mradul.garg{at}


A 10-year-old boy presented with a low volume feculent umbilical discharge associated with fever and anorexia. Exploratory laparotomy revealed a complex fistula communicating with multiple small bowel loops and extensive peritoneal nodules with caseous mesenteric lymph nodes; suggestive of abdominal tuberculosis. Fistulectomy, adhesiolysis and a diversion jejunostomy were done and antituberculosis therapy was started. A 20-year-old man presented with serous umbilical discharge, having a history of similar complaints in his infancy. While he was being investigated, he developed peritonitis and had to be operated on emergency basis. An umbilical sinus connected with a fibrous band to Meckel diverticulum and a proximal closed loop small bowel obstruction perforation were found. Resection and anastomosis of the affected segment were done, and the patient recovered well.

  • small intestine
  • TB and other respiratory infections
  • general surgery

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  • Contributors NA and NG conceived the manuscript. NA prepared the manuscript. NG and MV edited the manuscript. MG reviewed the manuscript. All the authors read and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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