Abstract
Congenital abdominal wall abnormalities are a common group of disorders that result from abnormal development of the abdominal wall. Ventral body wall defects range from the relatively minor umbilical and epigastric hernias to major defects such as gastroschisis and omphalocele. This chapter will focus on the embryology of the umbilicus and associated common umbilical defects and postnatal problems. The physiologic importance of the umbilicus and umbilical cord is far greater during fetal development than it is after birth. During abdominal wall development, the developing umbilicus serves a role in intestinal and urinary development and provides a life-sustaining opening that allows blood to flow between the placenta and fetus via the umbilical cord. After birth this conduit is no longer needed, and once the umbilical cord falls off, there should be no remaining connections. Nevertheless, umbilical disorders are frequently encountered.
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References
Pacilli M, Sebire NJ, Maritsi D, Kiely EM, Drake DP, Curry JI, Pierro A. Umbilical polyp in infants and children. Eur J Pediatr Surg. 2007;17(6):397–9.
Friedman JM. Umbilical dysmorphology. The importance of contemplating the belly button. Clin Genet. 1985;28(4):343–7.
Pomeranz A. Anomalies, abnormalities, and care of the umbilicus. Pediatr Clin North Am. 2004;51(3):819–27.
Christison-Lagay ER, Kelleher CM, Langer JC. Neonatal abdominal wall defects. Semin Fetal Neonatal Med. 2011;16(3):164–72.
Sadler TW. The embryologic origin of ventral body wall defects. Semin Pediatr Surg. 2010;19(3):209–14.
Blumberg NA. Infantile umbilical hernia. Surg Gynecol Obstet. 1980;150(2):187–92.
Skinner MA, Grosfeld JL. Inguinal and umbilical hernia repair in infants and children. Surg Clin North Am. 1993;73(3):439–49.
Skandalakis JE, Gray SW, Ricketts R. The anterior body wall. In: Skandalakis JE, Gray SW, editors. Embryology for surgeons. Philadelphia: Lippincott Williams & Wilkins; 1994. p. 563–8.
Cappele O, Sibert L, Descargues J, Delmas V, Grise P. A study of the anatomic features of the duct of the urachus. Surg Radiol Anat. 2001;23(4):229–35.
Hayward AR, Harvey BA, Leonard J, Greenwood MC, Wood CB, Soothill JF. Delayed separation of the umbilical cord, widespread infections, and defective neutrophil mobility. Lancet. 1979;1(8126):1099–101.
Novack AH, Mueller B, Ochs H. Umbilical cord separation in the normal newborn. Am J Dis Child. 1988;142(2):220–3.
Wilson CB, Ochs HD, Almquist J, Dassel S, Mauseth R, Ochs UH. When is umbilical cord separation delayed? J Pediatr. 1985;107(2):292–4.
Nagar H. Umbilical granuloma: a new approach to an old problem. Pediatr Surg Int. 2001;17(7):513–4.
Kutin ND, Allen JE, Jewett TC. The umbilical polyp. J Pediatr Surg. 1979;14(6):741–4.
Larralde de Luna M, Cicioni V, Herrera A, Casas JG, Magnin PH. Umbilical polyps. Pediatr Dermatol. 1987;4(4):341–3.
Moore TC. Omphalomesenteric duct malformations. Semin Pediatr Surg. 1996;5(2):116–23.
Rowe PC, Gearhart JP. Retraction of the umbilicus during voiding as an initial sign of a urachal anomaly. Pediatrics. 1993;91(1):153–4.
Hall DE, Roberts KB, Charney E. Umbilical hernia: what happens after age 5 years? J Pediatr. 1981;98(3):415–7.
Haller Jr JA, Morgan Jr WW, White JJ, Stumbaugh S. Repair of umbilical hernias in childhood to prevent adult incarceration. Am Surg. 1971;37(4):245–6.
Lassaletta L, Fonkalsrud EW, Tovar JA, Dudgeon D, Asch MJ. The management of umbilical hernias in infancy and childhood. J Pediatr Surg. 1975;10(3):405–9.
Little DC, Shah SR, St Peter SD, Calkins CM, Murphy JP, Gatti JM, Gittes GK, Sharp RJ, Andrews WS, Holcomb 3rd GW, Ostlie DJ, Snyder CL. Urachal anomalies in children: the vanishing relevance of the preoperative voiding cystourethrogram. J Pediatr Surg. 2005;40(12):1874–6.
Bertozzi M, Riccioni S, Appignani A. Laparoscopic treatment of symptomatic urachal remnants in children. J Endourol. 2014;28(9):1091–6.
Kosloske AM, Bartow SA. Debridement of periumbilical necrotizing fasciitis: importance of excision of the umbilical vessels and urachal remnant. J Pediatr Surg. 1991;26(7):808–10.
Lally KP, Atkinson JB, Woolley MM, Mahour GH. Necrotizing fasciitis. A serious sequela of omphalitis in the newborn. Ann Surg. 1984;199(1):101–3.
Samuel M, Freeman NV, Vaishnav A, Sajwany MJ, Nayar MP. Necrotizing fasciitis: a serious complication of omphalitis in neonates. J Pediatr Surg. 1994;29(11):1414–6.
Lee SL, DuBois JJ, Greenholz SK, Huffman SG. Advancement flap umbilicoplasty after abdominal wall closure: postoperative results compared with normal umbilical anatomy. J Pediatr Surg. 2001;36(8):1168–70.
Reyna TM, Hollis Jr HW, Smith SB. Surgical management of proboscoid herniae. J Pediatr Surg. 1987;22(10):911–2.
Minkes RK, Megison Sm, Chen LE, Mazziotti MV, Kim ES. Disorders of the Umbilicus. Medscape Drugs & Diseases. Updated Oct 20, 2014. Available at: http://emedicine.medscape.com/article/935618-overview. Accessed 1/10/16.
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Minkes, R.K., Mazziotti, M.V. (2017). Embryology of the Umbilicus and Associated Newborn Defects. In: Shiffman, M. (eds) Pediatric Umbilical Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-43890-0_1
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