UMBILICAL DEFECTS
During
the embryonic period at about the
tenth week of
fetal
life; the viscera normally return to
the abdominal cavity and the
abdominal wall closes slowly during
subsequent fetal development.
At birth, many infants will show a small
umbilical hernia because
this
process has not been completed (Fig. 24.8b). In most
cases
spontaneous closure occurs within the
first three years of life.
Rarely, the
process of abdominal
wall closure is
totally
incomplete at birth and omphalocele is present. The
defect at
the umbilicus is covered only by a
peritoneal sac.
In a few cases, the embyrologic duct
from small bowel to the yolk
sac (vitillo-intestinal duct) remains
patent and attached to the
umbilical cord at birth.
This
duct is likely
to be included in the
tie. When the
umbilical remanent sloughs later; a
fistula into the small gut is
created.
In
other cases; the tract from the bladder; the urachus
enters
the
umbilical arteries. The remnant
of the cephalic portion of
the
embryonic urinary bladder is
usually obliterated before
birth;
if it remains patent, it may become
involved in the
umbilical cord
ligature and a draining
umbilical sinus may
present.
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