A 4-Hour-Old Boy Is Evaluated in the Nursery for Routine

A 4-hour-old boy is evaluated in the nursery for routine newborn care.  The patient was born at 38 weeks gestation via spontaneous vaginal delivery to an 18-year-old woman who did not receive prenatal care or take prenatal vitamins.  Birth weight is 3.6 kg (8 lb) .  Vital signs are normal.  Examination shows a sleeping infant in no distress.  There is molding of the occiput.  A soft mass inferior to the umbilical stump is 1.4 cm in diameter and covered by skin.  The mass increases in size when the infant cries and reduces into the abdominal cavity with gentle pressure.  The mass does not seem to be tender to palpation.  The rest of the examination is normal.  Which of the following is the best next step in management of this patient's mass?

A) Abdominal ultrasound
B) Immediate surgery
C) Karyotype analysis
D) Observation only
E) Topical silver nitrate

Correct Answer:

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