Rectus sheath hernia

Last revised by Ayla Al Kabbani on 20 May 2022

Rectus sheath hernias (alternative plural: herniae) are a very seldom seen form of herniation through the anterior abdominal wall. Herniation of intra-abdominal contents (mesenteric fat +/- bowel), is usually through the posterior rectus sheath only and thus these are often termed posterior rectus sheath hernias. The hernia can extend to various degrees. 

These hernias are a subtype of the interparietal hernia group as the herniating tissue is interposed between the abdominal wall layers.

Most rectus sheath hernias have been found to result from surgical weakening of the wall or following trauma. Spontaneous cases are exceedingly rare, with a few in the medical literature.

A CT may give the best appreciation of the anatomy and is usually seen as a hernia within a large portion of the rectus sheath.

A rectus sheath hernia is thought to have been first reported in the literature in 1937 1-4.

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