Abdominal pain is a common childhood complaint, which can be caused by a mild stomach ache or severe intestinal malformations. A child will usually point to her belly button when asked to point to the pain. If pain is truly localised in the belly button area, rather than a specific quadrant of the belly or generalised in the belly, a physician is more likely to look for specific problems. Causes of belly button pain in children include a foreign object, appendicitis, bowel obstruction, Meckel's diverticulitis and infected urachal cyst.
When a child experiences belly button pain, "the obvious" must first be ruled out. Much to a parent's dismay, foreign objects can become painfully lodged in the belly button and require removal.
Abdominal pain associated with appendicitis typically starts near the belly button. As the appendicitis becomes more severe, the pain tends to shift to the right lower quadrant of the abdomen. In children, appendicitis always requires an appendectomy as soon as possible. However, if the appendix has an abscess, the child is treated with a course of antibiotics. The appendix is removed once the abscess heals.
Bowel obstruction can present as severe belly button pain in children. This usually occurs in children who have had prior abdominal surgery or have an incarcerated (non-reducable) inguinal hernia. Diagnosis is made by CT scan or radiologic examination of the small intestine, called a small bowel follow-through. Treatment usually requires surgery.
Meckel's diverticulum is a pouch-like formation on the wall of the small intestine. The pouch is congenital and may become infected, causing Meckel's diverticulitis. This causes sharp or cramping and mild to severe belly button pain in children. Symptoms are associated with blood in the stool. Treatment requires surgical removal of the diverticulum.
Infected Urachal Cyst
Infected urachal cysts are most common in infancy and early adulthood, and these cysts cause belly button pain and belly button erythema. The urachus is a tube-like embryological structure associated with developing bladder and urinary systems. In a fully developed foetus, the urachus closes, forming a string-like formation rather than a tube. On rare occasions, the urachus does not close. Cysts may form, fill with fluid and harbour bacteria. Infected urachal cysts require surgical removal.
- Pathologic Basis of Disease; R.S. Cotran, et. al.; 6th Ed; 1999
- Acute Abdominal Pain in Children; American Family Physician; AKC Leung and DL Sigalet; June 1, 2003
- An Unusual Presentation of a Urachal Cyst; Clinical Pediatrics; G Boyle, et al; 1988