male child age 4yrs having this on umbilical no pain no pus discharge since birth .Dc nd Rx

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Soft tissue USG of the region is advised prior to any intervention. As umbilical granuloma has pus discharge and ulcerative lesion. Umbilical hernia has impulse on cough and has good skin cover. persistent urachus may be another possibility.
since present from birth, consider congenital causes lasting for so long without complications.. it looks more like a remnant of vitellointestinal duct at the umbilical end called raspberry tumor. Please do an usg to look for underlying atrophied cord.
umbilical grabuloma Try antibiotic oint locally and systemic anti biotic .if not subsided then cauterization
Raspberry Umbilical granuloma. Requires excision
Umbilical granuloma or raspberry tumour.
raspberry umbilicus
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Umbilical hernia.
There's no discharge from umbilicus which is not favouring umbilical granuloma,patent urachus or parent patent vitelline intestinal duct. It's looks like URACHUS CYST which can be remove surgical after rule out it's patency. If patency with URACHUS is there than urachus should remove surgically otherwise locally it can get remove.
as much as simple umbilical hernia tried coin therapy at least 3month otherwise go for operation
Appears more like umbilical hernia requires operation only no other treatment
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