{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:01:06Z","timestamp":1784638866139,"version":"3.55.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous abdominal wall repair may alter the rectus abdominis muscle structure and render rectus sheath block (RSB) infeasible in pediatric cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 5-year-old boy with a history of siloplasty and omphalocele repair underwent right ventricle-to-pulmonary artery conduit replacement. Deep parasternal intercostal plane block and RSB had been planned. However, ultrasound pre-scanning failed to identify the rectus abdominis muscle in the upper abdomen, and the liver was visualized immediately beneath the abdominal wall. Preoperative computed tomography confirmed absence of the rectus abdominis muscle, rendering RSB anatomically infeasible. An alternative upper abdominal wall block was performed. The patient was extubated 2\u00a0h after admission to the intensive care unit and had no apparent discomfort from the chest and mediastinal drains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preprocedural ultrasound assessment can identify altered rectus abdominis muscle structure and help anesthesiologists select a safer and potentially effective alternative analgesic strategy when RSB is not feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-026-00863-7","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:35:01Z","timestamp":1779694501000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound identification of absent rectus abdominis muscle after omphalocele repair altered regional anesthesia strategy in pediatric cardiac surgery: a case report"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7926-7976","authenticated-orcid":false,"given":"Tomohiro","family":"Yamamoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teppei","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-7067","authenticated-orcid":false,"given":"Shuichi","family":"Shiraishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"863_CR1","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1136\/bmj.322.7284.473","volume":"322","author":"DW Wilmore","year":"2001","unstructured":"Wilmore DW, Kehlet H. 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This article is a case report and does not report a research study involving human participants.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient\u2019s parents for publication of this case report and accompanying images\/video.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"27"}}