Arcuate line of rectus sheath

The arcuate line of rectus sheath, the linea semicircularis, the arcuate line, or the semicircular line of Douglas, is a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath. It is commonly known simply as the arcuate line. It is also where the inferior epigastric vessels perforate the rectus abdominis.

"Linea semicircularis" redirects here. It is not to be confused with Linea semilunaris.
Arcuate line of rectus sheath
The interfoveolar ligament, seen from in front. (Linea semicircularis labeled at center top.)
Details
Identifiers
LatinLinea arcuata vaginae musculi recti abdominis
TA98A04.5.01.006
TA22362
FMA16919
Anatomical terminology

Structure

Superior to the arcuate line, the internal oblique muscle aponeurosis splits to envelop the rectus abdominis muscle both anteriorly and posteriorly. The anterior layer is derived from the external oblique aponeurosis and the anterior lamina of the internal oblique aponeurosis.[1] The posterior layer is made up of the posterior lamina of the internal oblique aponeurosis and the transversus abdominis aponeurosis.

Inferior to the arcuate line, the aponeuroses of the external oblique muscle, the internal oblique muscle, and the transversus abdominis muscle merge and pass superficial to the rectus abdominis muscle.[1] Therefore, inferior to the arcuate line, the rectus abdominis rests directly on the transversalis fascia.

The arcuate line occurs about half of the distance from the umbilicus to the pubic crest, but this varies from person to person.

If one dissects the anterolateral abdominal wall, the arcuate line may be difficult to see, since all the aponeuroses are translucent.

[2]

Clinical significance

Spigelian hernias and, exceedingly rarely, arcuate line hernias may occur inferior to the arcuate line.

The arcuate line must be incised at its lateral-most point in order to enter the space of Retzius and space of Bogros from within the rectus sheath during surgery during retrorectus repair and transversus abdominis release.

History

The arcuate line is also known as the linea semicircularis, and the semicircular line of Douglas.[3]

References
  1. Raj, Prasanta K.; Sidhu, Ramandeep S.; Taylor, Michael D.; Buckley, Brooke M.; Scarcipino, Mario A. (2005-03-01). "New anatomic repair of midline abdominal wall incisions extending to suprapubic region". Current Surgery. 62 (2): 226–230. doi:10.1016/j.cursur.2004.07.015. ISSN 0149-7944.
  2. Montgomery, A.; Petersson, U.; Austrums, E. (2013-06-01). "The arcuate line hernia: operative treatment and a review of the literature". Hernia. 17 (3): 391–396. doi:10.1007/s10029-012-0982-6. ISSN 1248-9204.
  3. Cavagna, E.; Carubia, G.; Schiavon, F. (June 2000). "[Anatomo-radiologic correlations in spontaneous hematoma of the rectus abdominis muscles]". La Radiologia Medica. 99 (6): 432–437. ISSN 0033-8362. PMID 11262819.
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