Abdomen & Back
The umbilical cord should have two arteries and one vein. A single umbilical artery is seen in 1% of babies and is sometimes associated with other congenital anomalies.
Umbilical hernia is common and usually closes spontaneously before two years of age.
The liver normally extends 2 cm below the costal margin, and the tip of the spleen can sometimes be felt. Both kidneys can be palpated. Abnormal masses such as Wilm's tumor, neuroblastoma, hydronephrosis or a multicystic-dysplastic kidney or renal vein thrombosis can be easily palpated. A tight abdomen or persistent abdominal distention suggests intestinal obstruction or ascites.
The back should be checked for midline defects; a shallow sacral dimple is a common and normal finding. However, a deep dimple needs to be further investigated.
