Rebound tenderness overview: Difference between revisions
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===Medical Therapy=== | ===Medical Therapy=== | ||
[[Blood volume]] should be immediately replaced with [[saline]] and/or [[blood transfusion]] for those patients that are hemodynamically unstable and bowel rest for [[diverticulitis]] or [[bowel obstruction]] (possible [[colon]] resection). | [[Blood volume]] should be immediately replaced with [[saline]] and/or [[blood transfusion]] for those patients that are hemodynamically unstable and bowel rest for [[diverticulitis]] or [[bowel obstruction]] (possible [[colon]] resection). | ||
===Surgery=== | |||
Indications for surgery when elicited would be as a result of life threatening emergencies such as; early [[sepsis]] or evidence of [[hemorrhage]], which would require immediate surgical intervention, ruptured [[aneurysm]], [[ectopic pregnancy]], [[bowel perforation]] or other pathologies require definite surgical repair. | |||
==References== | ==References== | ||
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[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 19:15, 12 June 2015
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Rebound tenderness Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Rebound tenderness overview On the Web |
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American Roentgen Ray Society Images of Rebound tenderness overview |
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Risk calculators and risk factors for Rebound tenderness overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Rebound tenderness is one of the most important signs of peritonitis when evaluating an acute abdomen. In recent years the value of rebound tenderness has been questioned, since it may not add any diagnostic value beyond the observation that the patient has severe tenderness.
Pathophysiology
Rebound tenderness is thought to be due to stretching of the peritoneum.
Epidemiology and Demographics
Children, the immunocompromised, and the elderly are less likely to show peritoneal signs and may have atypical presentations.
Diagnosis
Physical Examination
Rebound tenderness is a clinical sign that a doctor may detect in physical examination of a patient's abdomen. It refers to pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.) To elicit the sign, gentle pressure is placed on the abdomen and then the hand is lifted suddenly. A sudden increase in abdominal pain occurs when the examiner's hand is lifted. The other physical examination findings to distinguish rebound tenderness are abdominal tenderness and guarding.
Treatment
Medical Therapy
Blood volume should be immediately replaced with saline and/or blood transfusion for those patients that are hemodynamically unstable and bowel rest for diverticulitis or bowel obstruction (possible colon resection).
Surgery
Indications for surgery when elicited would be as a result of life threatening emergencies such as; early sepsis or evidence of hemorrhage, which would require immediate surgical intervention, ruptured aneurysm, ectopic pregnancy, bowel perforation or other pathologies require definite surgical repair.