Concern for umbilical hernia. Periumbilical tenderness. Targeted evaluation of the patient's umbilicus shows a 2.3 x 2.1 x 2.2 cm anechoic cystic/fluid collection with echogenic shadowing nonvascular components. No evidence of bowel contents and/or peristalsis. Minimal surrounding subcutaneous fat induration but no drainable fluid collection. No significant change in the collection with Valsalva maneuver.
Probable small periumbilical hernia containing fluid and herniating fat without evidence of bowel in the hernia sac. If further evaluation is clinically warranted a CT may be obtained.