Anatomic Basis for Imaging Assessment of the Postsurgical Anterolateral Abdominal Wall

Postoperative evaluation of the abdominal wall requires an understanding of anatomy, surgical techniques, and potential complications. While many abdominal surgical procedures involve the wall as a conduit to intra-abdominal organs, targeted abdominal wall procedures such as hernia repairs, ostomy creation, aesthetic operations, and complex reconstructions present imaging challenges and possible complications. The authors provide a structured approach to postoperative abdominal wall imaging, integrating detailed anatomic knowledge with common surgical interventions. They address the relationship between surgical techniques and complication patterns, including mesh behavior, nerve-related muscle changes, and fascial disruptions. The expected postoperative appearance, stages of healing, and early and late complications of various procedures are highlighted, with dedicated sections on hernias, mesh repairs, ostomies, and aesthetic surgery. CT is usually the primary imaging modality, with US and MRI serving complementary roles when appropriate. By aligning imaging interpretation with surgical terminology and classifications, radiologists can improve diagnostic accuracy, ensure reporting consistency, and better support multidisciplinary decision making. ^©RSNA, 2026 Supplemental material is available for this article.