Rektusdiastase

Diastasis recti (rectus diastasis) or divarication of the recti is a stretching of the linea alba with abnormal widening of the gap between the two medial sides of the rectus abdominis muscle (increased inter-recti distance).

The degree of widening needed for the diagnosis is controversial, with the degree of abdominal protrusion (rather than the degree of widening) often defining whether it is pathological. However, >15-25 mm is usually considered abnormal depending on gender, parity and if postpartum, time since birth. Additionally, the normal width varies depending on the level at which the linea alba is measured (narrower at the xiphoid and inferiorly approaching the pubic symphysis, and widest at the level of the umbilicus).

Epidemiology

Diastasis recti occurs primarily in newborns and pregnant women, although it can also occur in men and postpartum women .

Pathology

• newborn
  • rectus abdominis is not fully developed and may not be sealed together at midline
  • more common in premature and black newborns
• pregnant or postpartum women
  • growing uterus stretches the rectus abdominis
  • diastasis is more common in multiparous women due to repeated stretching

Treatment and prognosis

Diastasis recti is not a true hernia and, therefore, not associated with risk of strangulation. Repair (abdominoplasty) is primarily done for cosmetic reasons based more on degree of abdominal protrusion rather than the diastasis itself. It is performed by folding the linea alba and suturing together to create a tighter abdominal wall.

Differential diagnosis

• abdominal wall hernia

Siehe auch:

• Musculus rectus abdominis