In human

anatomy Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...

, the median umbilical ligament is an unpaired midline ligamentous structure upon the lower inner surface of the anterior abdominal wall. It is covered by the median umbilical fold. The median umbilical ligament represents the remnant of the

fetal A fetus or foetus (; : fetuses, foetuses, rarely feti or foeti) is the unborn offspring of a viviparous animal that develops from an embryo. Following the embryonic stage, the fetal stage of development takes place. Prenatal development is a ...

urachus. It extends from the apex of the

bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...

to the umbilicus, on the deep surface of the anterior abdominal wall. The median umbilical ligament represents one of the five ligaments of the internal anterior abdominal wall inferior to the umbilicus; laterally on either side of it are one medial umbilical ligament and finally one lateral umbilical ligament.

Development

The median umbilical ligament begins as the allantois in the embryonic period. It then becomes the urachus in the

fetus A fetus or foetus (; : fetuses, foetuses, rarely feti or foeti) is the unborn offspring of a viviparous animal that develops from an embryo. Following the embryonic development, embryonic stage, the fetal stage of development takes place. Pren ...

. This later develops into the median umbilical ligament at birth. It is also formed from the

cloaca A cloaca ( ), : cloacae ( or ), or vent, is the rear orifice that serves as the only opening for the digestive (rectum), reproductive, and urinary tracts (if present) of many vertebrate animals. All amphibians, reptiles, birds, cartilagin ...

in utero.

Function

The median umbilical ligament has no known function.

Clinical significance

The median umbilical ligament may be used as a landmark for surgeons who are performing laparoscopy, such as laparoscopic

inguinal hernia An inguinal hernia or groin hernia is a hernia (protrusion) of abdominal cavity contents through the inguinal canal. Symptoms, which may include pain or discomfort especially with or following coughing, exercise, or bowel movements, are absen ...

repair. Other than this, it has no function in a born human and may be cut or removed with impunity. It contains the urachus, which is the obliterated form of the allantois. The allantois forms a communication between the

(terminal part of

hindgut The hindgut (or epigaster) is the posterior ( caudal) part of the alimentary canal. In mammals, it includes the distal one third of the transverse colon and the splenic flexure, the descending colon, sigmoid colon and up to the ano-rectal junct ...

) and the

amniotic sac The amniotic sac, also called the bag of waters or the membranes, is the sac in which the embryo and later fetus develops in amniotes. It is a thin but tough transparent pair of biological membrane, membranes that hold a developing embryo (and l ...

during

embryonic development In developmental biology, animal embryonic development, also known as animal embryogenesis, is the developmental stage of an animal embryo. Embryonic development starts with the fertilization of an egg cell (ovum) by a sperm, sperm cell (spermat ...

. If the urachus fails to close during fetal life, it can result in anatomical abnormalities such as a urachal cyst, urachal fistula, urachal diverticulum or urachal sinus. In very rare cases the urachus can fail to close fully. This can lead to a condition known as a '' patent urachus'' (also ''urachal fistula''). Although it is mainly immediately diagnosed after birth it can occur at any stages of life. In this condition there is a functional tubular connection between the umbilicus and the bladder which can lead to urine draining through the umbilicus. Patients often present with umbilical wetness or recurring infections in the area. Treatment options include laparoscopic surgery, excision of the umbilicus or conservative therapy. Due to limited risks conservative therapy, while still being chosen rarely, has been gaining some traction in the last years.

Society and culture

The median umbilical ligament was jokingly referred to as "Xander's ligament" in a

YouTube YouTube is an American social media and online video sharing platform owned by Google. YouTube was founded on February 14, 2005, by Steve Chen, Chad Hurley, and Jawed Karim who were three former employees of PayPal. Headquartered in ...

video published by Dr. Alexander R. Toftness (aka. ARTexplains on YouTube), and this name was subsequently used on

Wikipedia Wikipedia is a free content, free Online content, online encyclopedia that is written and maintained by a community of volunteers, known as Wikipedians, through open collaboration and the wiki software MediaWiki. Founded by Jimmy Wales and La ...

for a short time. This term was later used in a paper published in Mayo Clinic Proceedings. The term has also appeared in a medical textbook of

obstetrics Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a su ...

and

gynaecology Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine concerned with conditions affecting the female reproductive system. It is often paired with the field of obstetrics, which focuses on pre ...

References

External links

* Median umbilical ligament ** - "The inguinal canal and derivation of the layers of the spermatic cord." ** - "The Male Pelvis: The Urinary Bladder" ** * Median umbilical fold ** - "Internal surface of the anterior abdominal wall." {{Authority control Abdomen Ligaments