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omphalolith, 배꼽 제석, 배꼽돌을 캐내다 - 동대문구 답십리, 용답동, 우리안애 우리안愛 내과

80대 초반 여자

근처 내과에서 혈압/고지혈 투약중

20년, 22년 본원에서 일차검진, 암검진

20년 대장내시경 시행, 선종 하나

약 2주전 방문시...대장암 검사 상의위해 내원하였으나.. 추가로

배꼽이 올라온다. 진료실에서 처음 보기에 처음 떠오른 단어는...

Sister Mary Joseph nodule? 전이에 의한 배꼽 병변으로 가벼운 단어는 아닌데..

손톱으로 뜯어보니 뜯기는 양상으로 살덩어리는 아닌것으로 보이며...

물에 불려보도록 안내하고 진료를 종료하였다.

그리고, 찾아보니 omphalolith였다.

Omphalolith is a rare and underdiagnosed entity due to the accumulation of sebum and keratin in the umbilicus. 드물고 진단이 잘 안되는 정체.. 피지와 케라틴이 배꼽에 쌓인것 It usually occurs in the elderly with deep and narrow umbilicus. 고령에서 깊은 배꼽에 발생 Early recognition of omphalolith is important to prevent complications, unnecessary investigations, and anxiety. 합병증이나, 불필요한 검사, 걱정을 예방하기 위해 일찍 발견하는 것이 중요

Omphalolith or umbilical concretion is a rare and benign affection due to the accumulation of sebum and keratin in the umbilicus. 3 , 4 It usually presents as a firm black mass. The pigmented color of the majority of omphaloliths is explained by melanin accumulation and lipid oxidation. 5

Omphalolith mainly affects elderly women with deep and narrow umbilicus and poor corporal hygiene. 6 Obesity is another predisposing factor.

Omphalolith usually remains asymptomatic for several years. It can be noticed by chance or after secondary complications. 4 Repetitive trauma can cause irritation, erosions, bleeding, and pyogenic granuloma. Secondary infection, abscess formation, cellulite, or even peritonitis can also be the revealing symptoms of this condition. 4 , 5 , 7

감기 진료 위해 재내원

모습은 아래와 같으며

The diagnosis of omphalolith is based on clinical examination. Dermoscopy shows aggregates of pigmented keratin. If a histopathological examination is performed, it reveals laminated keratin associated with amorphous sebaceous material. 임상적 모습에서 진단.. 조직검사를 하기도..

Differential diagnoses 감별진단 include malignant tumors comprising Mary Joseph's nodule and malignant melanoma. Benign affections can mimic umbilical concretion such as keloids, umbilical endometriosis, dermatofibroma, cholesteatoma, foreign bodies like terminal hairs (trichobezoar), and persistent omphalomesenteric duct. 1 , 3 , 7 Therefore, early recognition of omphalolith is important to prevent unnecessary investigations. However, in some difficult and complicated cases, imaging like magnetic resonance imaging (MRI) can be useful to rule out an umbilical sinus. 2

The treatment consists of a gentle extraction of the calculus using forceps. 6 , 7 In our cases, it allowed the extraction of the entire mass with no bleeding. A prior softening with glycerin or olive oil may facilitate its extraction. 7 Excision of an associated pyogenic granuloma can be necessary in some cases. Patients' education on proper corporeal hygiene is paramount to prevent recurrences. 4 , 5 , 7 The excision of the umbilicus may be recommended in some recalcitrant cases. 1

포셉을 이용하여 큰 덩어리를 제거하고

젖은 알콜솜으로 피부에 붙어 있는 때? 를 불리면서 거의 제거할 수 있었다.

Happy ending, 행복한 결말이었다.

산부인과나 외과에서 배꼽을 통한 수술을 할때 자주 접하기는 한다고 합니다.

동대문구 답십리 우리안애, 우리안愛 내과, 건강검진 클리닉 내과 전문의 전병연


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