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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2016, Vol. 10 Issue (3) : 271-277     DOI: 10.1007/s11684-016-0457-8
Anatomy and embryology of umbilicus in newborns: a review and clinical correlations
Abdelmonem A. Hegazy()
Department of Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
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Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, “one vein and two arteries,” embedded in Wharton’s jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications.

Keywords anatomy      embryology      newborns      umbilicus     
Corresponding Authors: Abdelmonem A. Hegazy   
Just Accepted Date: 28 June 2016   Online First Date: 29 July 2016    Issue Date: 30 August 2016
URL:     OR
Fig.1  Diagrams showing the (A) folding of the embryo and formation of the primitive umbilical cord and (B) definitive umbilical cord.
Fig.2  Diagram showing the arrangement of the ligaments at the umbilicus.
Fig.3  Diagrams showing vitelline duct’s remnants.
1 Tamilselvan K, Mohan A, Cheslyn-Curtis S, Eisenhut M. Persistent Umbilical Discharge from an Omphalomesenteric Duct Cyst Containing Gastric Mucosa. Case Rep Pediatr, 2012; 2012: 482185
doi: 10.1155/2012/482185
2 Abhyankar A, Lander AD. Umbilical disorders. Surgery (Oxford) 2004; 22(9): 214–217
3 Shaw WW, Aston SJ, Zide BM. Reconstruction of the trunk. In: McCarthy JG. Plastic Surgery. Vol. 6. Philadelphia: WB Saunders, 1990. 3675–3796
4 Marconi F. Reconstruction of the umbilicus: a simple technique. Plast Reconstr Surg 1995; 95(6): 1115–1117
doi: 10.1097/00006534-199505000-00028 pmid: 7732126
5 Fawkner-Corbett D, Nicholson JA, Bullen T, Cross P, Bailey D, Scott MH. Anatomical variation in the position of the umbilicus and the implications for laparoscopic surgery. Int J Surg 2010; 8(7): 540–578
doi: 10.1016/j.ijsu.2010.07.118
6 Du-Plessis DJ. A Synopsis of Surgical Anatomy. 11th ed. Bristol: John Wright and Son Ltd., 1975
7 Smith T. Fundamentals of Anesthesia. 3rd ed. Cambridge: Cambridge University Press, 2009
8 Williams AM, Brain JL. The normal position of the umbilicus in the newborn: an aid to improving the cosmetic result in exomphalos major. J Pediatr Surg 2001; 36(7): 1045–1046
doi: 10.1053/jpsu.2001.24737 pmid: 11431773
9 Snell R. Clinical Anatomy by Regions. 9th ed. Lippincott, 2012
10 Sellers J, Newman JH. Disinfection of the umbilicus for abdominal surgery. Lancet 1971; 298(7737): 1276–1278
doi: 10.1016/S0140-6736(71)90599-X pmid: 4143533
11 April EW. Anatomy: the National Medical Series for Independent Study. 2nd ed. A Wily medical publication, 1990
12 Hegazy AA. Clinical Embryology for Medical Students and Postgraduate Doctors. Berlin: Lap Lambert Academic Publishing, 2014
13 Schoenwolf GC, Bleyl SB, Brauer PR, Francis-West PH. Larsens Human Embryology. 5th ed. Churchill Livingstone, 2015
14 Sadler TW. Langman’s Medical Embryology. 13th ed. Baltimore, 2015
15 Steding G. The Anatomy of the Human Embryo: Scanning Electron-Microscopic Atlas. Karger, Basel, 2008
16 Khati NJ, Enquist EG, Javitt MC. Imaging of the umbilicus and periumbilical region. Radiographics 1998; 18(2): 413–431
doi: 10.1148/radiographics.18.2.9536487 pmid: 9536487
17 Sinnatamby CS. Last’s Anatomy: Regional and Applied. 11th ed. Churchill Livingstone, 2006
18 Merkle EM, Gilkeson RC. Remnants of fetal circulation: appearance on MDCT in adults. AJR Am J Roentgenol 2005; 185(2): 541–549
doi: 10.2214/ajr.185.2.01850541 pmid: 16037534
19 Razvi S, Murphy R, Shlasko E, Cunningham-Rundles C. Delayed separation of the umbilical cord attributable to urachal anomalies. Pediatrics 2001; 108(2): 493–494
doi: 10.1542/peds.108.2.493 pmid: 11483823
20 Joseph T, Lander AD. Childhood hernias related to the umbilicus. Surgery 2005; 23(9): 326–327
doi: 10.1383/surg.2005.23.9.326
21 Poenaru D. Disorders of the umbilicus in infants and children: A consensus statement of the Canadian Association of Paediatric Surgeons. Paediatr Child Health 2001; 6(6): 312–313
pmid: 20084253
22 Poddar R, Hartley L. Exomphalos and gastroschisis. BJA: CEACCP 2009; 9(2): 48–51
doi: 10.1093/bjaceaccp/mkp001
23 Durakbasa CU, Okur H, Mutus HM, Bas A, Ozen MA, Sehiralti V, Tosyali AN, Zemheri IE. Symptomatic omphalomesenteric duct remnants in children. Pediatr Int 2010; 52(3): 480–484
doi: 10.1111/j.1442-200X.2009.02980.x pmid: 19863751
24 Morresey PR. Umbilical Problems. Focus on the first year of life proceedings/2014. Available at:
25 Farhat AS, Mohammadzadeh A. Comparison between two and twenty-four hours salt powder in treatment of infant umbilical granuloma. Iran Red Crescent Med J 2008; 10(4): 267–269
26 Nagar H. Umbilical granuloma: a new approach to an old problem. Pediatr Surg Int 2001; 17(7): 513–514
doi: 10.1007/s003830100584 pmid: 11666047
27 Pierce BT, Dance VD, Wagner RK, Apodaca CC, Nielsen PE, Calhoun BC. Perinatal outcome following fetal single umbilical artery diagnosis. J Matern Fetal Med 2001; 10(1): 59–63
doi: 10.1080/jmf. pmid: 11332422
28 Jones KL, Benirschke K, Chambers CD. Gastroschisis: etiology and developmental pathogenesis. Clin Genet 2009; 75(4): 322–325
doi: 10.1111/j.1399-0004.2009.01164.x pmid: 19419414
29 Kravitz H. Temperature of the umbilicus. J Pediatr 1966; 68(3): 418–422
doi: 10.1016/S0022-3476(66)80245-7 pmid: 5903312
30 Cameron GS, Lau GYP. The umbilicus as a site for temporary colostomy in infants. J Pediatr Surg 1982; 17(4): 362–364
doi: 10.1016/S0022-3468(82)80489-2 pmid: 7120002
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