The white line, also by its Latin name linea alba, is a fibrous band located along the anterior abdominal wall.

Position. The white line forms the midline of the abdomen1. It starts at the level of the sternum, the central bone and in front of the rib cage, and extends vertically to the pubic symphysis, a joint connecting the hip bones at the front (2).

Structure. The white line is formed by the coming together of the tendon fibers of the muscles, the aponeuroses. The white line thus constitutes a tendinous raphe. It is also crossed by the umbilicus, also known as the navel, a fibrous scar that appears following the fall of the umbilical cord (3). The umbilicus makes it possible to distinguish two parts of the white line:

• Above the umbilicus, the white line is wide.
• Below the umbilicus, the white line is narrow.

Site d’insertion. The white line provides an insertion site for different muscles of the abdominal wall: the internal and external oblique muscles, as well as the transverse muscles (1) (2).

Separation zone. The white line separates the rectus abdominis muscles, the main vertical muscles of the anterior wall of the abdomen (1).

Navel formation during the fall of the umbilical cord. At birth, the umbilical cord, which is no longer needed by the baby, is cut. A few centimeters of the umbilical cord remains attached to the baby for five to eight days before loosening and drying out (1). The healing phenomenon begins and reveals the shape of the navel at the level of the white line.

White line hernia. Different types of hernias can develop on the white line. These hernias may contain fat or part of the digestive organs (4).

• Epigastric hernia. Most often asymptomatic, it occurs between the sternum and the umbilicus. Its size can be very variable.
• Umbilical hernia. It constitutes the form is the most frequent. Visible in the form of a bump at the level of the navel, it is formed by the exit of part of the contents of the abdomen (intestines, fat, etc.) through the navel (5). It is necessary to treat it to avoid complications like constricted intestines.
• Hypogastric hernia. This rare form can appear under the umbilicus.

Laparoschisis and omphalocele. These two rare congenital malformations (6) (7) manifest as incomplete closure or absence of the abdominal wall, respectively. They require medical care from birth (8).

Abdominal pain and cramps. Frequent, they can have different causes and appear on the white line. They are often associated with the intestines and to a lesser extent with the stomach or pancreas.

Drug treatments. Depending on the causes of abdominal pain and cramps, antispasmodics or laxatives may be prescribed. Herbal or homeopathic treatments can also be applied in some cases.

Surgical treatment. In the case of a hernia or birth defects, surgery may be necessary.

Physical examination. The diagnosis begins with an evaluation of the pain perceived by the patient at the level of the white line and the navel.

Medical imaging exams. Abdominal CT scan, parietal ultrasound, or even MRI can be used to complete the diagnosis.

Laparoscopy. This examination consists of the insertion of an instrument (laporoscope), coupled to a light source, through a small opening made under the navel. This exam allows you to visualize the inside of the abdomen.

Visibility of the white line. The white line appears as a vertical skin depression along the midline of the abdomen (1).