Embryologic Development and Defects · USMLE Step 1

A newborn has a midline abdominal defect with herniation of abdominal organs covered only by a thin membrane. Which embryologic failure is most likely responsible?

  1. Failure of lateral folds to fuse
  2. Persistence of the vitelline duct
  3. Incomplete return of midgut to the abdomen
  4. Incomplete fusion of urorectal septum
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Correct answer: Incomplete return of midgut to the abdomen

Omphalocele results from failure of the herniated midgut to return to the abdominal cavity. The organs remain covered by a peritoneal and amniotic membrane, unlike gastroschisis, which has no covering and arises from lateral body-fold failure.

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