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Umbilical and peri umbilical pathology

Find assessment and management information at Brisbane South HealthPathways under:

Useful management information

  • Provide reassurance
    • most are elective surgical conditions
    • umbilical hernias are a common condition and more than 95% will self-resolve by 2-3 years
    • epigastric hernias are largely asymptomatic and do not necessarily require surgery
  • Umbilical polyps can be difficult to distinguish from vitello-intestinal tract (VIT) remnants. VIT remnants typically do not respond to silver nitrate
  • Central short lived colicy abdominal pain without redness, irreducibility or systemic effect is not usually due to the concurrent presence of an umbilical hernia in children
  • In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
  • Paediatric surgery registrars at Queensland Children's Hospital and GCUH can offer telephone advice to rural HHS. In some areas it would be more appropriate to seek initial advice from local paediatric medical service or general surgery services
    • Queensland Children's Hospital: 07 3068 1111
    • GCUH: 1300 744 284
  • Next of kin or person(s) who is legally responsible for patient consent, with the exception of children under guardianship orders with the Department of Communities, Child Safety and Disability services, should be present at the first outpatient appointment

Minimum referral criteria (Does your patient meet the minimum criteria?)

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark “urgent” on your referral

  • Discharging umbilical lesions under 3 months of age
  • Polyps not responding to silver nitrate
Category 2
(appointment within 90 calendar days)
  • Epigastric or umbilical hernia associated with intermittent redness with pain
  • Nodular non-inflamed irreducible lesions representing cystic umbilical remnants
Category 3
(appointment within 365 calendar days)
  • Umbilical hernia still present after 2 years of age
  • Asymptomatic epigastric hernia where parents wish to discuss surgery
  • Parental anxiety not reassured by GP

If your patient does not meet the minimum referral criteria

  • Find assessment and management information at Brisbane South HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

 

Essential referral information for Umbilical and peri umbilical pathology referrals (Referral will be returned without this)

  • General referral information

Additional referral information for Umbilical and peri umbilical pathology referrals

  • Nature of any umbilical discharge
  • Treatments that have been applied to date and efficacy

Emergency Immediate transfer to the Emergency Department

If any of the following are present or suspected, please refer the patient to emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region

Paediatric surgery registrars at Queensland Children's Hospital/ GCUH can offer telephone advice to rural HHS. In some areas it would be more appropriate to seek initial advice from local paediatric medical service or general surgery services:

  • Queensland Children's Hospital: 07 3068 1111
  • GCUH: 1300 744 284

Umbilical and peri umbilical pathology

  • Any painful, red, or irreducible hernia – discuss with on-call paediatric surgical registrar
  • Suspected vitello-intestinal remnant or patent urachus

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 21 December 2023