Anatomy of the Abdominal Wall

Abstract

The abdominal wall encompasses an area of the body bounded superiorly by the xiphoid process and costal arch, and inferiorly by the inguinal ligament, pubic bones and the iliac crest. Visualization, palpation, percussion, and auscultation of the anterolateral abdominal wall may reveal abnormalities associated with abdominal organs, such as the liver, spleen, stomach, abdominal aorta, pancreas and appendix, as well as thoracic and pelvic organs. Visible or palpable deformities such as swelling and scars, pain and tenderness may reflect disease processes in the abdominal cavity or elsewhere. Pleural irritation as a result of pleurisy or dislocation of the ribsmay result in pain that radiates to the anterior abdomen. Pain from a diseased abdominal organ may refer to the anterolateral abdomen and other parts of the body, e.g., cholecystitis produces pain in the shoulder area as well as the right hypochondriac region. The abdominal wall should be suspected as the source of the pain in individuals who exhibit chronic and unremitting pain with minimal or no relationship to gastrointestinal function, but which shows variation with changes of posture [1]. This is also true when the anterior abdominal wall tenderness is unchanged or exacerbated upon contraction of the abdominal muscles (positive Carnett’s sign). Abdominal wall pain can be the result of localized endometriosis, rectus sheath hematoma, or abdominal incision or hernia.