Sonographic anatomy of the rectus sheath: an indication for new terminology and implications for rectus flaps

With the aim of standardizing descriptions of lesions on the anterior abdominal wall and definition of reconstructive flaps, the sonographic anatomy of the rectus sheath has been studied in 8 subjects. Anatomic terms have been suggested for the various segments and intersections of the sheath. The linea abla, linea semilunaris, formation of rectus sheath, segments and intersections have been described and illustrated. Identical segments and intersections were found to have characteristic sonographic features in all subjects. The intersection below the umbilicus was observed in 1 out of 8. Ultrasound capability in the determination of size and extent of tissues is discussed. It is hoped that the use of the suggested terminology and the preoperative ultrasonic definition of rectus flaps, may provide basis for objective comparison of results of reconstructive surgery.