A hernia of the linea alba refers to a hernia that occurs along the midline of the abdominal wall, known as the linea alba. The vast majority of these hernias occur above the umbilicus and are therefore also referred to as epigastric hernias. The tendinous fibers of the linea alba cross obliquely, and during abdominal distension, the linea alba must simultaneously elongate and widen. This process may tear the crossing tendinous fibers, gradually leading to the formation of a hernia in the linea alba.
The falciform ligament is located deep to the linea alba in the upper abdomen, and the extraperitoneal fat contained within it is often the initial content of an early-stage hernia of the linea alba. As the condition progresses, the peritoneum may be drawn outward, forming a hernial sac into which intra-abdominal tissues can pass through the neck of the sac. In the lower abdomen, the rectus abdominis muscles are positioned more closely together, giving the linea alba of the lower abdominal wall greater structural strength, which makes hernias in this region rare.
In the early stages, hernias of the linea alba are typically small and asymptomatic. However, as the condition progresses, traction on the peritoneum may cause significant epigastric pain, along with symptoms such as indigestion, nausea, and vomiting. Small hernias without notable symptoms may not require treatment, whereas surgical intervention may be performed in cases with significant symptoms.
Surgical treatment generally involves excising protruding fat and suturing the defect in the linea alba. If a hernial sac is present, ligation of the neck of the hernial sac, excision of the sac, and repair of the defect in the linea alba are performed. For larger defects in the linea alba, artificial polymer repair materials can be used to reinforce the area.