The rectus abdominis muscles should meet in the midline at the linea alba. Superior to the umbilicus, some people have a congenital defect that results in a widened linea alba. As a result, when a patient flexes the abdominal muscles the rectus muscles spread apart (divaricate).
Divarication and abdominal hernias appear very similiar. To differentiate between a divarication and a hernia clinically:
- get the patient to do a sit-up - rectus muscles spread apart in both a hernia and a divarication
- get the patient to cough - rectus muscles will only split apart if its a hernia. When coughing all abdominal muscles are used (not just the rectus), so a divarication will show a diffuse bulging, rather than locally down the midline.
Divarication is common in obese men. It can be surgically corrected, although such an operation would be almost entirely for cosmetic purposes and not of any functional value (unlike a hernia).
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