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Background <p>The increasing use of cross-sectional imaging—particularly abdominal computed tomography (CT)—together with the global rise in obesity has brought renewed attention to a fat-containing structure posterior to the umbilical scar that is frequently labeled as an “umbilical hernia” in radiology reports. Historical anatomical literature, however, describes this configuration as the <i>umbilical canal</i>, a variable, habitus-dependent space between the posterior surface of the linea alba and a reinforcing lamella of the transversalis fascia, often filled with preperitoneal fat and containing embryologic remnants of the umbilical vessels.</p> Purpose <p>To revisit the anatomical foundations of the umbilical canal, correlate classical descriptions with modern CT appearances, and examine how contemporary surgical risk metrics may be inappropriately extrapolated to this structure.</p> Discussion <p>Classical anatomical and surgical literature—from Scarpa, Richet, Gauderon, and Cullen to early twentieth-century surgical pathology—consistently distinguishes true umbilical hernia, defined by a peritoneal-lined sac, a fascial neck, and visceral content, from preperitoneal fat protrusions within the linea alba. Modern CT imaging frequently demonstrates a funnel-shaped, fat-filled tract posterior to the umbilical scar that corresponds to the historically described umbilical canal rather than a true hernia. Because this configuration lacks a peritoneal sac and a discrete fascial neck, applying hernia-based morphologic risk metrics may lead to diagnostic ambiguity.</p> Conclusion <p>Recognizing the umbilical canal as a distinct anatomical configuration rather than a true umbilical hernia may improve terminological precision in radiology reporting, enhance interdisciplinary communication, and help avoid potential overdiagnosis and unnecessary surgical referral.</p>

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The umbilical canal revisited: historical anatomy and radiologic implications of a commonly misnamed CT finding

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月9日

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  • André Vaz,
  • Vinícius Cardoso Serra,
  • Camila Pietroski Reifegerste

摘要

Background

The increasing use of cross-sectional imaging—particularly abdominal computed tomography (CT)—together with the global rise in obesity has brought renewed attention to a fat-containing structure posterior to the umbilical scar that is frequently labeled as an “umbilical hernia” in radiology reports. Historical anatomical literature, however, describes this configuration as the umbilical canal, a variable, habitus-dependent space between the posterior surface of the linea alba and a reinforcing lamella of the transversalis fascia, often filled with preperitoneal fat and containing embryologic remnants of the umbilical vessels.

Purpose

To revisit the anatomical foundations of the umbilical canal, correlate classical descriptions with modern CT appearances, and examine how contemporary surgical risk metrics may be inappropriately extrapolated to this structure.

Discussion

Classical anatomical and surgical literature—from Scarpa, Richet, Gauderon, and Cullen to early twentieth-century surgical pathology—consistently distinguishes true umbilical hernia, defined by a peritoneal-lined sac, a fascial neck, and visceral content, from preperitoneal fat protrusions within the linea alba. Modern CT imaging frequently demonstrates a funnel-shaped, fat-filled tract posterior to the umbilical scar that corresponds to the historically described umbilical canal rather than a true hernia. Because this configuration lacks a peritoneal sac and a discrete fascial neck, applying hernia-based morphologic risk metrics may lead to diagnostic ambiguity.

Conclusion

Recognizing the umbilical canal as a distinct anatomical configuration rather than a true umbilical hernia may improve terminological precision in radiology reporting, enhance interdisciplinary communication, and help avoid potential overdiagnosis and unnecessary surgical referral.