Anatomy of the Anterior Abdominal Wall

The anterior abdominal wall can be considered to have six specific defined layers, all of which play a part in achieving successful reconstruction of the abdominal wall. The six layers from superficial to deep are: skin and subcutaneous fat, the superficial fascia, the muscular layers, transversalis fascia, pre-peritoneal fat and the peritoneum itself. The nerve supply to the abdominal wall is carried in the anterior rami of the 5th–12th thoracic and the 1st lumbar spinal nerves. The role of cross-sectional imaging, predominantly CT, has come to the fore in recent years in the assessment and planning of complex abdominal wall hernias and their reconstruction, and it is essential that practitioners have a sound working knowledge of the normal anatomy on CT and be able to assess variations from the norm. The muscles of the abdominal wall are described in three anatomically distinct areas, two postero-lateral areas and a central strip running down the front of the abdominal wall.