Skip to main content
Log in

The arcuate line hernia: operative treatment and a review of the literature

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

An arcuate line hernia (ALH) is a rare diagnosis with no consensus on how to deal with this condition either when symptomatic or when found accidentally. Suggestions for laparoscopic and open operative techniques are given together with a review of the literature and a presentation of three new cases.

Material

The PubMed database was searched for publications on ALH. Identified cases, including three from our department, are reported.

Results

Five males and two females, with a median age of 53 years were identified. Three patients were correctly diagnosed on a preoperative CT scan and the rest at surgery. Two patients had bilateral ALHs and four had other concomitant hernias repaired. Small bowel was present in the hernia in three cases and sigmoid colon in one. In one case, an emergency operation was performed due to bowel incarceration. Five patients had laparoscopic repairs, three with mesh and two without. Two patients, one converted from laparoscopic to open operation, had open mesh repairs. The postoperative course was uneventful in all cases, and no recurrences have been reported at a median follow-up of 6 months.

Conclusions

A laparoscopic approach is recommended for diagnostic purposes, for pre-peritoneal mesh placement and for repair of concomitant hernias in both elective and emergency settings. Highlighting its existence might help general surgeons in interpreting an unusual finding on a CT scan or at operation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cappeliez O, Duez V, Alle JL, Leclercq F (2003) Bilateral arcuate-line hernia. Am J Roentgenol 180(3):864–865

    Article  Google Scholar 

  2. Coulier B (2007) Multidetector computed tomography features of linea arcuata (arcuate-line of Douglas) and linea arcuata hernias. Surg Radiol Anat 29(5):397–403

    Article  PubMed  CAS  Google Scholar 

  3. von Meyenfeldt EM, van Keulen EM, Eerenberg JP, Hendriks ER (2010) The linea arcuata hernia: a report of two cases. Hernia 14:207–209

    Article  Google Scholar 

  4. Abasbassi M, Hendrickx T, Caluwé G, Cheyns P (2011) Symptomatic linea arcuata hernia. Hernia 15(2):229–231

    Article  PubMed  CAS  Google Scholar 

  5. Rizk NN (1991) The arcuate line of the rectus sheath—does it exist? J Anat 175:1–6

    PubMed  CAS  Google Scholar 

  6. Monkhouse W, Khalique A (1986) Variations in the composition of the human rectus sheath: a study of the anterior abdominal wall. J Anat 145:61–66

    PubMed  CAS  Google Scholar 

  7. Cunningham SC, Rosson GD, Lee RH, Willians JZ, Lustman CA, Slezak S, Goldberg NH, Silverman RP (2004) Localization of the arcuate line from surface anatomic landmarks:a cadaveric study. Ann Plast Surg 53(2):129–131

    Article  PubMed  Google Scholar 

  8. Loukas M, Mayers C, Shah R, Tubbs RS, Wartmann C, Apaydin N, Betanor J, Jordan R (2008) Arcuate line of the rectus sheath: clinical approach. Anat Sci Int 83(3):140–144

    Article  PubMed  Google Scholar 

  9. Mwachaka PM, Saidi HS, Odula PO, Awori KO, Kaisha WO (2010) Locating the arcuate line of Douglas: is it of surgical relevance? Clin Anat 23(1):84–86

    PubMed  CAS  Google Scholar 

  10. Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P (2006) Spigelian hernia: surgical anatomy, embryology and technique of repair

  11. Spangen L (1989) Spigelian hernia. World J Surg 13(5):573–580

    Article  PubMed  CAS  Google Scholar 

  12. Losanoff JE, Basson MD, Gruber SA (2009) Spontaneous hernia through the posterior rectus abdominis sheath: case report and review of published literature 1937–2008. Hernia 13:555–558

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Montgomery.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Montgomery, A., Petersson, U. & Austrums, E. The arcuate line hernia: operative treatment and a review of the literature. Hernia 17, 391–396 (2013). https://doi.org/10.1007/s10029-012-0982-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-012-0982-6

Keywords

Navigation