Relationship between rectal abdominis muscle position and physiological umbilical herniation and return: A morphological and morphometric study.

Abstract

The herniation of the intestinal loop (IL) in the extraembryonic coelom and its return to abdominal cavity is in parallel with the formation of the rectal abdominis muscle (RAM). Using high-resolution magnetic resonance imaging data of human fetuses (n = 19, CRL22-69 mm; stored at Kyoto Collection), this study aimed to analyze the relationship between the development of RAM and phase of IL herniation. The RAM runs at the lateral part of the abdominal wall in the small samples in the herniation phase. The position was shifted to the midline area in the larger samples in the herniation phase. According to fetal growth, the caudal ends of the muscles extended along the umbilical ring towards the pubis, though the caudal part of the RAMs were thin and faint in most of the samples. Length measurements related with the growth of the abdominal wall including RAM and abdominal circumference showed positive correlation with fetal growth. On the contrary, diastasis of RAMs and the width and area of the umbilical ring were almost constant according to fetal growth. Such morphometric value showed no obvious changes regardless of the phases of herniation. The ratio of the width and diastasis of the RAMs to the circumference was decreased, indicating that the closure of the ventral body wall was influenced by growth differences. The present data indicate that the formation of the abdominal wall including RAM is independent of the phase of IL herniation, whether in the extraembryonic coelom or in the abdominal cavity.