Rebound tenderness overview
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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 from are abdominal tenderness and guarding.