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Examination of umbilicus

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.