A 26-year-old male canoeist was referred with a 10-day history of abdominal pain, and a palpable mass in the left upper quadrant. No history of direct trauma was given. He was not taking any medication, and malignancy and inflammatory conditions were considered in the differential diagnosis. Ultrasonographic scan identified a mass originating in the rectus abdominis sheath. Ultrasonographically...

The anterior cutaneous branches of the thoracolumbar spinal nerves enter the rectus sheath at its lateral border and perforate the muscle after travelling a short distance in the ventral direction. In this anatomical case series, we show that dye injection at the medial margin did not lead to reliable impregnation of the target nerves. The local anesthetic should therefore be injected at the la...

Editor’s key points † Umbilical hernia repair in children is associated with considerable postoperative discomfort. † Rectus sheath blocks (RSBs) and local anaesthetic infiltration of the surgical site (LAI) are used for providing postoperative analgesia for umbilical hernia repair. † Ultrasound-guided RSB provides superior analgesia in the perioperative period compared with LAI for umbilical h...

HISTORY OF THE RECTUS SHEATH BLOCK Abdominal field block was first described in 1899 by Schleich.1 Various methods of abdominal field block have been used in anaesthetic practice over recent decades. A technique involving multiple injections of local anaesthetic in the abdominal wall was used in the 1980’s.2 This technique was simplified with a single injection non-ultrasound technique used thr...