Rebound test for appendicitis. Rebound Tenderness and Blumberg’s Sign: Understanding Peritonitis Diagnosis

01.09.202309.06.2023 by alexxlab

What is Blumberg’s sign and how is it used to diagnose peritonitis. How does a doctor check for rebound tenderness. What are the common causes of peritonitis and its symptoms.

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Understanding Rebound Tenderness and Blumberg’s Sign

Rebound tenderness, also known as Blumberg’s sign, is a crucial diagnostic tool used by medical professionals to identify peritonitis, an inflammation of the peritoneum – the membrane lining the abdominal cavity. This simple yet effective test can provide valuable insights into a patient’s condition, potentially indicating a serious abdominal issue that requires immediate attention.

The Diagnostic Procedure

During the examination, a doctor applies pressure to a specific area of the patient’s abdomen using their hands. They then quickly remove their hands and observe the patient’s reaction. If the patient experiences pain or discomfort when the skin and tissue return to their original position, it’s considered a positive result for rebound tenderness.

This test is particularly useful in differentiating between superficial abdominal pain and deeper, more serious conditions affecting the peritoneum. A positive Blumberg’s sign can be indicative of peritoneal inflammation, which often results from an underlying infection or other abdominal issues.

Common Symptoms Associated with Peritonitis

While rebound tenderness is a key indicator, peritonitis often presents with a constellation of symptoms. Patients experiencing this condition may report:

Abdominal pain or tenderness, especially during movement
Bloating or feelings of fullness, even without eating
Fatigue and unusual thirst
Constipation and reduced urination
Loss of appetite accompanied by nausea and vomiting
Fever

It’s crucial for patients to communicate these symptoms to their healthcare provider, including details about onset and any factors that exacerbate or alleviate the discomfort. This information, combined with the results of the rebound tenderness test, aids in forming an accurate diagnosis and treatment plan.

Underlying Causes of Peritonitis

Peritonitis is often the result of an infection that affects the peritoneum. There are several potential causes for this condition, each with its own set of risk factors and implications for treatment.

Perforation and Abdominal Wall Breaches

One of the primary causes of peritonitis is a perforation or opening in the abdominal wall. This breach can allow bacteria from the digestive tract or external environment to enter the peritoneal cavity, leading to infection and inflammation. In some cases, this can result in the formation of an abscess – a pocket of pus that further complicates the condition.

Pelvic Inflammatory Disease (PID)

In female patients, pelvic inflammatory disease can be a precursor to peritonitis. PID is an infection of the reproductive organs, including the uterus, fallopian tubes, and ovaries. If left untreated, bacteria from these infected organs can migrate to the peritoneum, causing widespread inflammation.

Complications from Medical Procedures

Certain medical interventions carry a risk of introducing infection to the peritoneal cavity. For instance, patients undergoing dialysis may require catheter tubes inserted through the peritoneum to access the kidneys. If proper sterilization protocols are not followed, this can lead to peritonitis. Similarly, any abdominal surgery carries an inherent risk of postoperative infection, which can spread to the peritoneum if not promptly addressed.

Liver Disease and Its Impact on Peritoneal Health

Liver cirrhosis, characterized by scarring of liver tissue, can have far-reaching effects on abdominal health. One potential complication is ascites – the accumulation of fluid in the abdominal cavity. When this fluid buildup becomes excessive, it can create an environment conducive to bacterial growth, leading to a condition known as spontaneous bacterial peritonitis.

The Connection Between Cirrhosis and Peritonitis

Patients with advanced liver disease are particularly susceptible to peritoneal infections. The compromised immune function associated with cirrhosis, combined with the presence of ascitic fluid, creates an ideal breeding ground for bacteria. Regular monitoring and prompt treatment of ascites in cirrhotic patients is crucial in preventing the onset of peritonitis.

Gastrointestinal Conditions Leading to Peritonitis

Several gastrointestinal issues can potentially progress to peritonitis if left untreated or if complications arise. Understanding these conditions is essential for both prevention and early intervention.

Appendicitis and Its Complications

A ruptured appendix is a medical emergency that can quickly lead to peritonitis. When an infected or inflamed appendix bursts, it releases bacteria into the abdominal cavity. Swift removal of the appendix or immediate medical treatment is crucial to prevent the spread of infection and the onset of peritonitis.

Stomach Ulcers and Perforations

Stomach ulcers, particularly perforated peptic ulcers, pose a significant risk for peritonitis. These ulcers can create openings in the stomach lining, allowing stomach contents and bacteria to enter the abdominal cavity. The resulting infection can rapidly progress to peritonitis if not promptly addressed.

Pancreatitis and Its Consequences

Inflammation or infection of the pancreas (pancreatitis) can have serious implications for peritoneal health. In severe cases, the infection can spread beyond the pancreas and into the abdominal cavity. Additionally, pancreatitis can lead to a condition called acute chylous ascites, where a fluid called chyle leaks from lymph nodes into the abdomen, potentially causing peritonitis.

Intestinal Disorders and Their Role in Peritonitis

Certain intestinal conditions can increase the risk of peritonitis by compromising the integrity of the digestive tract. One such condition is diverticulitis, an inflammation of small pouches (diverticula) that form in the intestinal wall.

Diverticulitis and Peritoneal Risk

When diverticula become inflamed or infected, they can cause perforations in the digestive tract. These openings provide a pathway for bacteria to enter the abdominal cavity, potentially leading to peritonitis. Prompt treatment of diverticulitis is essential to prevent such complications and maintain overall abdominal health.

The Importance of Timely Diagnosis and Treatment

Peritonitis is a serious condition that requires immediate medical attention. The rebound tenderness test, or Blumberg’s sign, serves as a valuable initial screening tool, but it’s just one part of a comprehensive diagnostic approach. Healthcare providers may employ additional tests, including blood work, imaging studies, and in some cases, peritoneal fluid analysis to confirm the diagnosis and determine the underlying cause.

Treatment Approaches for Peritonitis

Once diagnosed, treatment for peritonitis typically involves a combination of interventions:

Antibiotic therapy to combat the infection
Intravenous fluids to address dehydration and electrolyte imbalances
Pain management
In some cases, surgical intervention to address the underlying cause (e.g., removing a ruptured appendix or repairing a perforated ulcer)

The specific treatment plan will depend on the severity of the condition, the underlying cause, and the patient’s overall health status. Early intervention is crucial in preventing complications and improving outcomes.

Preventive Measures and Long-term Management

While not all cases of peritonitis are preventable, there are steps individuals can take to reduce their risk:

Prompt treatment of underlying conditions such as appendicitis, diverticulitis, or peptic ulcers
Adhering to proper hygiene protocols, especially for patients undergoing dialysis or other medical procedures
Regular health check-ups to monitor conditions that may predispose to peritonitis, such as liver disease
Maintaining a healthy lifestyle to support overall immune function

For patients with chronic conditions that increase the risk of peritonitis, long-term management strategies may include ongoing medical supervision, dietary modifications, and in some cases, preventive antibiotic regimens.

Understanding the significance of rebound tenderness and its relationship to peritonitis empowers both patients and healthcare providers. By recognizing the symptoms and risk factors associated with this condition, individuals can seek timely medical attention, potentially averting serious complications. As medical knowledge continues to advance, diagnostic techniques and treatment approaches for peritonitis will likely evolve, offering hope for improved outcomes and quality of life for affected individuals.

Rebound Tenderness and Blumberg’s Sign: Definition and Causes

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Medically reviewed by J. Keith Fisher, M.D. — By Tim Jewell — Updated on January 25, 2019

What is Blumberg’s sign?

Rebound tenderness, also called Blumberg’s sign, is something your doctor might check for when diagnosing peritonitis.

Peritonitis is the inflammation of the membrane on the inside of your abdominal wall (the peritoneum). It’s usually caused by an infection, which can be the result of many things.

Read on to learn more about how a doctor checks for rebound tenderness and what it means for your health.

To check for rebound tenderness, a doctor applies pressure to an area of your abdomen using their hands. They quickly remove their hands and ask if you feel any pain when the skin and tissue that was pushed down moves back into place.

If you do feel pain or discomfort, you have rebound tenderness. If you don’t feel anything, it helps your doctor to rule out peritonitis as a cause of your symptoms.

If you experience rebound tenderness, you might also have some of the following symptoms:

stomach pain or tenderness, especially when you move
feelings of fullness or bloating, even if you haven’t eaten anything
fatigue
unusual thirst
constipation
reduced urination
loss of appetite
nausea
vomiting
fever

Make sure to tell you doctor about any of these symptoms, including when you first noticed them and anything that makes them better or worse.

Rebound tenderness is a sign of peritonitis, a serious condition that is an inflammation of the peritoneum. This inflammation often results from an infection.

Many things can cause the underlying infection, including:

Perforation. A hole or opening in your abdominal wall can let bacteria in, either from your digestive tract or from outside your body. This can cause an infection of your peritoneum that can lead to an abscess, which is a collection of pus.
Pelvic inflammatory disease. Pelvic inflammatory disease (PID) results from an infection of the female reproductive organs, including the uterus, fallopian tubes, or ovaries. Bacteria from these organs can move into the peritoneum and cause peritonitis.
Dialysis. You may need catheter tubes inserted into your kidneys through your peritoneum to drain fluid during dialysis. An infection can happen if the tubes or medical facility aren’t properly sterilized.
Liver disease. Scarring of liver tissue, known as cirrhosis, can cause ascites, which refers to the buildup of fluid in your abdomen. If too much fluid builds up, it can cause a condition called spontaneous bacterial peritonitis.
Surgery complication. Any kind of surgery, including in your abdominal area, carries a risk of infection in the surgical wound.
Ruptured appendix. An infected or injured appendix can burst, spreading bacteria into your abdomen. An abdominal infection can quickly turn into peritonitis if your ruptured appendix isn’t removed or treated right away.
Stomach ulcer. A stomach ulcer is a sore that can appear on your stomach lining. A certain type of ulcer known as a perforated peptic ulcer can create an opening in the stomach lining, causing an infection in the abdominal cavity.
Pancreatitis. Inflammation or infection of your pancreas can spread into your abdominal cavity and cause peritonitis. Pancreatitis can also cause a fluid called chyle to leak from your lymph nodes into your abdomen. This is known as acute chylous ascites and can cause peritonitis.
Diverticulitis. Diverticulitis happens when small pouches in your intestines, called diverticula, get inflamed and infected. This can cause perforations in your digestive tract and make you vulnerable to peritonitis.
Abdominal injury. Trauma or injury to your abdomen can injure your abdominal wall, making the peritoneum more susceptible to inflammation, infection, or other complications.

If you think you have peritonitis, see your doctor right away.

An abdominal infection can lead to serious complications if it’s left untreated.

If a doctor finds that you do have rebound tenderness, they’ll likely follow up with a few other tests to narrow down a diagnosis.

These tests include:

Guarding vs. rigidity test. Guarding involves voluntarily flexing your abdominal muscles, making your abdomen feel firm to the tough. Rigidity is abdominal firmness that’s not related to flexing muscles. Your doctor can tell the difference by gently touching your abdomen and seeing if firmness decreases when you relax.
Percussion tenderness test. A doctor will gently but firmly tap on your abdomen to check for pain, discomfort, or tenderness. The abrupt tapping will likely cause pain if you have peritonitis.
Cough test. You’ll be asked to cough while a doctor checks for any flinching or other signs of pain. If coughing causes pain, you may have peritonitis.

Depending on your other symptoms, a doctor might order some laboratory tests as well, including:

blood tests
urine tests
imaging tests
kidney function tests
liver function tests
analysis of abdominal fluid

They may also use a CT scan or MRI scan to look at your abdominal tissue and organs.

If a doctor confirms that you have peritonitis, there are several treatment options, depending on the underlying cause. These include:

antibiotics for bacterial infections
surgery to remove infected tissue, a burst appendix, diseased liver tissue, or to address issues in your stomach or intestines
pain medication for any pain or discomfort from inflammation

Rebound tenderness isn’t a condition itself. Instead, it’s usually a sign of peritonitis. Without quick treatment, peritonitis can cause lasting health complications.

Seek immediate medical attention if you experience unusual abdominal bloating and pain, especially if you haven’t eaten anything recently.

Last medically reviewed on September 5, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Complications: Appendicitis. (2016).
nhs.uk/conditions/appendicitis/complications/
Georgiou GK, et al. (2012). Acute chylous peritonitis due to acute pancreatitis.
ncbi.nlm.nih.gov/pmc/articles/PMC3337577/
Mayo Clinic Staff. (2018). Diverticulitis.
mayoclinic.org/diseases-conditions/diverticulitis/symptoms-causes/syc-20371758
Mayo Clinic Staff. (2018). Pelvic inflammatory disease (PID).
mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
Mayo Clinic Staff. (2018). Peritonitis.
mayoclinic.org/diseases-conditions/peritonitis/symptoms-causes/syc-20376247
McGee S. (2012). Chapter 48: Abdominal pain and tenderness in “Evidence-based physical diagnosis.”
pdfs.semanticscholar.org/b476/4638ca3553a568f30e08ad848f262dc618c8.pdf
Peritonitis. (n.d.).
hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/peritonitis_85,P00391
Ribeiro TCR, et al. (2008). Spontaneous bacterial peritonitis: How to deal with this life-threatening cirrhosis complication?
ncbi.nlm.nih.gov/pmc/articles/PMC2621420/
Schietroma M, et al. (2013). Peritonitis from perforated peptic ulcer and immune response.
ncbi.nlm.nih.gov/pubmed/23514054
Vermeulen J, et al. (2010). Treatment of perforated diverticulitis with generalized peritonitis: Past, present, and future. DOI:
10.1007/s00268-009-0372-0

Share this article

Medically reviewed by J. Keith Fisher, M.D. — By Tim Jewell — Updated on January 25, 2019

Rebound Tenderness and Blumberg’s Sign: Definition and Causes

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  - Alzheimer’s & Dementia
  - Bipolar Disorder
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  - Cold & Flu
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  - Depression
  - Fibromyalgia
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  - HIV
  - Hypertension
  - IPF
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  - Mood Foods
  - Align Your Spine
- Find Care
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Medically reviewed by J. Keith Fisher, M.D. — By Tim Jewell — Updated on January 25, 2019

What is Blumberg’s sign?

Rebound tenderness, also called Blumberg’s sign, is something your doctor might check for when diagnosing peritonitis.

Peritonitis is the inflammation of the membrane on the inside of your abdominal wall (the peritoneum). It’s usually caused by an infection, which can be the result of many things.

Read on to learn more about how a doctor checks for rebound tenderness and what it means for your health.

If you do feel pain or discomfort, you have rebound tenderness. If you don’t feel anything, it helps your doctor to rule out peritonitis as a cause of your symptoms.

If you experience rebound tenderness, you might also have some of the following symptoms:

stomach pain or tenderness, especially when you move
feelings of fullness or bloating, even if you haven’t eaten anything
fatigue
unusual thirst
constipation
reduced urination
loss of appetite
nausea
vomiting
fever

Make sure to tell you doctor about any of these symptoms, including when you first noticed them and anything that makes them better or worse.

Rebound tenderness is a sign of peritonitis, a serious condition that is an inflammation of the peritoneum. This inflammation often results from an infection.

Many things can cause the underlying infection, including:

Perforation. A hole or opening in your abdominal wall can let bacteria in, either from your digestive tract or from outside your body. This can cause an infection of your peritoneum that can lead to an abscess, which is a collection of pus.
Pelvic inflammatory disease. Pelvic inflammatory disease (PID) results from an infection of the female reproductive organs, including the uterus, fallopian tubes, or ovaries. Bacteria from these organs can move into the peritoneum and cause peritonitis.
Dialysis. You may need catheter tubes inserted into your kidneys through your peritoneum to drain fluid during dialysis. An infection can happen if the tubes or medical facility aren’t properly sterilized.
Liver disease. Scarring of liver tissue, known as cirrhosis, can cause ascites, which refers to the buildup of fluid in your abdomen. If too much fluid builds up, it can cause a condition called spontaneous bacterial peritonitis.
Surgery complication. Any kind of surgery, including in your abdominal area, carries a risk of infection in the surgical wound.
Ruptured appendix. An infected or injured appendix can burst, spreading bacteria into your abdomen. An abdominal infection can quickly turn into peritonitis if your ruptured appendix isn’t removed or treated right away.
Stomach ulcer. A stomach ulcer is a sore that can appear on your stomach lining. A certain type of ulcer known as a perforated peptic ulcer can create an opening in the stomach lining, causing an infection in the abdominal cavity.
Pancreatitis. Inflammation or infection of your pancreas can spread into your abdominal cavity and cause peritonitis. Pancreatitis can also cause a fluid called chyle to leak from your lymph nodes into your abdomen. This is known as acute chylous ascites and can cause peritonitis.
Diverticulitis. Diverticulitis happens when small pouches in your intestines, called diverticula, get inflamed and infected. This can cause perforations in your digestive tract and make you vulnerable to peritonitis.
Abdominal injury. Trauma or injury to your abdomen can injure your abdominal wall, making the peritoneum more susceptible to inflammation, infection, or other complications.

If you think you have peritonitis, see your doctor right away.

An abdominal infection can lead to serious complications if it’s left untreated.

If a doctor finds that you do have rebound tenderness, they’ll likely follow up with a few other tests to narrow down a diagnosis.

These tests include:

Guarding vs. rigidity test. Guarding involves voluntarily flexing your abdominal muscles, making your abdomen feel firm to the tough. Rigidity is abdominal firmness that’s not related to flexing muscles. Your doctor can tell the difference by gently touching your abdomen and seeing if firmness decreases when you relax.
Percussion tenderness test. A doctor will gently but firmly tap on your abdomen to check for pain, discomfort, or tenderness. The abrupt tapping will likely cause pain if you have peritonitis.
Cough test. You’ll be asked to cough while a doctor checks for any flinching or other signs of pain. If coughing causes pain, you may have peritonitis.

Depending on your other symptoms, a doctor might order some laboratory tests as well, including:

blood tests
urine tests
imaging tests
kidney function tests
liver function tests
analysis of abdominal fluid

They may also use a CT scan or MRI scan to look at your abdominal tissue and organs.

If a doctor confirms that you have peritonitis, there are several treatment options, depending on the underlying cause. These include:

antibiotics for bacterial infections
surgery to remove infected tissue, a burst appendix, diseased liver tissue, or to address issues in your stomach or intestines
pain medication for any pain or discomfort from inflammation

Rebound tenderness isn’t a condition itself. Instead, it’s usually a sign of peritonitis. Without quick treatment, peritonitis can cause lasting health complications.

Seek immediate medical attention if you experience unusual abdominal bloating and pain, especially if you haven’t eaten anything recently.

Last medically reviewed on September 5, 2018

How we reviewed this article:

Complications: Appendicitis. (2016).
nhs.uk/conditions/appendicitis/complications/
Georgiou GK, et al. (2012). Acute chylous peritonitis due to acute pancreatitis.
ncbi.nlm.nih.gov/pmc/articles/PMC3337577/
Mayo Clinic Staff. (2018). Diverticulitis.
mayoclinic.org/diseases-conditions/diverticulitis/symptoms-causes/syc-20371758
Mayo Clinic Staff. (2018). Pelvic inflammatory disease (PID).
mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
Mayo Clinic Staff. (2018). Peritonitis.
mayoclinic.org/diseases-conditions/peritonitis/symptoms-causes/syc-20376247
McGee S. (2012). Chapter 48: Abdominal pain and tenderness in “Evidence-based physical diagnosis.”
pdfs.semanticscholar.org/b476/4638ca3553a568f30e08ad848f262dc618c8.pdf
Peritonitis. (n.d.).
hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/peritonitis_85,P00391
Ribeiro TCR, et al. (2008). Spontaneous bacterial peritonitis: How to deal with this life-threatening cirrhosis complication?
ncbi.nlm.nih.gov/pmc/articles/PMC2621420/
Schietroma M, et al. (2013). Peritonitis from perforated peptic ulcer and immune response.
ncbi.nlm.nih.gov/pubmed/23514054
Vermeulen J, et al. (2010). Treatment of perforated diverticulitis with generalized peritonitis: Past, present, and future. DOI:
10.1007/s00268-009-0372-0

Share this article

Medically reviewed by J. Keith Fisher, M.D. — By Tim Jewell — Updated on January 25, 2019

Five tips on how to recognize appendicitis in time

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06/08/2011 23:10

Tatyana Volodina

It is estimated that in our country acute appendicitis overtakes about a million people every year.

Mortality due to it seems to be low: only 0.2-0.3%, but such insignificant figures hide about 3,000 human lives that doctors cannot save. And in the summer, when many people are in their country houses and far from doctors, it is especially important to be able to distinguish appendicitis from ordinary abdominal pain in order to see a doctor in time.

Blind but dangerous

The appendix is a short and thin blind appendix 7-10 cm long, located at the end of the caecum (the initial part of the large intestine). Like any part of the intestine, the appendix produces intestinal juice, but so little that it does not play a special role in digestion. Therefore, for a long time it was considered a “error of nature” and was removed by the sick at the first opportunity. But recently, scientists have found lymphoid cells in the blind process, the same as in the human tonsils. And since these cells have the ability to protect the body from infections, the assumption was born that the appendix is part of the immune system.

However, the number of protective cells in it, as it turned out, is very small and cannot have a strong effect on immunity. So most experts are still sure that there is no benefit from the appendix, but the harm in case of its inflammation can be significant: acute appendicitis not diagnosed in time can cost not only health, but also life.

Are your teeth to blame?

Experts do not agree on the exact causes of appendicitis. However, risk groups are identified.

For example, people suffering from diseases such as chronic tonsillitis, pneumonia, prolonged colds, diseases of the gastrointestinal tract, caries. As a result of these diseases, infections penetrate the bloodstream into the appendix and provoke an inflammatory process there. So healthy teeth – a guarantee of health for the appendix.

There is also a stress theory. It is based on the fact that as a result of excitement in a person there is a sharp narrowing of the blood vessels and this leads to a sudden bleeding of the appendix and the development of its inflammation.

But most often the occurrence of appendicitis is explained by blockage of the junction of the large intestine and the appendix, which often happens with constipation and chronic colitis.

How to identify him?

In most people, the appendix is located about half way between the navel and the right ilium. In this place, with appendicitis, the maximum pain is felt. But if the appendix is raised to the right hypochondrium, closer to the liver, pain will appear in this area. And if the appendix is lowered into the lower part of the pelvis, then in women, appendicitis is easily confused with inflammation of the appendages, in men – the bladder.

When the process is located behind the caecum, when it is wrapped to the kidney and ureter, there is pain in the lower back, it radiates to the groin, to the leg, to the pelvic area. If the process is directed inside the abdomen, then pains appear closer to the navel, in the middle section of the abdomen and even under the spoon.

Pain occurs suddenly without any obvious cause . At first they are not too strong – they can still be tolerated. And sometimes, from the first minutes of an attack of acute appendicitis, they become unbearable and proceed like colic.

Pain will torment a person as long as the nerve endings of the process are alive. When its necrosis occurs, the nerve cells will die and the pain will subside. But this is no reason for reassurance. Appendicitis will not “resolve” . On the contrary, the retreat of pain is a reason for immediate hospitalization. Acute appendicitis is accompanied by other symptoms. At the beginning of the disease, there is a general malaise, weakness, appetite worsens. Nausea may soon occur, and sometimes vomiting, but only once. Typical temperature in the range of 37.2-37.7 degrees, sometimes accompanied by chills. A white or yellowish coating appears on the tongue.

Appendicitis can be recognized with simple tricks. But, keep in mind, self-diagnosis must be carried out very carefully.

1 . Lightly tap with the pad of a bent index finger in the area of \u200b\u200bthe right iliac bone – with appendicitis, it always hurts there.

2 . For comparison, also tap on the left iliac region, which in case of inflammation of the appendix will not cause pain. Attention: you cannot palpate (palpation of the abdomen with your hands) yourself, there is a danger of tearing the appendix, which usually leads to peritonitis.

3. Try to cough loudly: increased pain in the right iliac region will tell you that you have appendicitis.

4 . Press lightly with the palm of your hand in the area of the abdomen where it hurts the most. Hold your hand here for 5-10 seconds. This will ease the pain a bit. Now take your hand away. If pain appears at this point, this is a sign of acute appendicitis.

5 . Take the fetal position, that is, lie on your right side and pull your legs towards your torso. Appendicitis relieves abdominal pain. If you turn on your left side and straighten your legs, it will intensify. This is also a sign of acute appendicitis.

But the self-diagnosis should be limited to this. Do not hesitate to see a doctor, because appendicitis itself, and all the diseases that it can disguise as (renal colic, exacerbation of pancreatitis or cholecystitis, peptic ulcers of the stomach and duodenum, acute inflammation of the bladder, kidneys, female organs), require hospitalization!

How to Treat

If acute appendicitis is diagnosed, the first treatment is emergency surgery. Currently, there is a sparing laparoscopic method in which the appendix can be removed without a large incision. Unfortunately, in our country, this type of operation is not yet widespread due to the poor technical equipment of hospitals.

The main task of the postoperative period is to avoid complications, such as suppuration of the postoperative wound. In their occurrence most often there is no fault of the surgeon. And to be this complication or not to be, depends on the state of the appendix at the time of the operation – the greater the degree of inflammation, the higher the risk of suppuration.

If the operation was successful, young patients will have their sutures removed on the 6-7th day and discharged from the hospital. But for the elderly, as well as for chronic diseases (diabetes mellitus, hypertension, cardiac ischemia, etc.), the stitches are removed 2-3 days later. After that, it is desirable to fasten the wound with adhesive tape.

Do not take a bath or go to the sauna for about a month: water and temperature loads on the fragile scar tissue make the seam rougher, wider and uglier. At least three months, and the elderly should not lift weights for six months. Avoid sports activities that cause tension in the abdominal muscles. Try not to catch a cold: it is dangerous for you to cough.

Severe case

If you try to “endure” appendicitis, you may experience peritonitis – inflammation of the abdominal cavity. Its symptoms:

increasing pain all over the abdomen, nausea, vomiting, in severe cases – drowsiness, lethargy, bluish complexion;

pulse up to 120-140 beats per minute, temperature up to 39-40 C;

tongue coated with white, then becomes dry like a crust, lips dry and cracked;

The abdomen is swollen, it hurts in all its areas, but especially on the right side.

Peritonitis is treated only by surgery. Moreover, the operation is very complex and lengthy. Unfortunately, it is not always possible to save the patient. That is why, with the appearance of any pain in the abdomen, in no case should you delay a visit to the doctor. As they say, we do not want to scare anyone, but everyone should remember how dangerous appendicitis is.

Rossiyskaya gazeta – Week – Federal issue: №124(5500)

Likbez

Health

You only have 24 hours to avoid deadly complications.

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Appendicitis is an inflammation of the appendix, that is, a process of the caecum. This is a small organ that has ceased to participate in digestion.

Most often, it becomes inflamed in people 10-30 years old, but in general you can get sick at any age.

In the Russian Federation, up to a million people experience appendicitis every year. The risk that this disease will sooner or later occur in you is about 7%.

If you do not seek help in time, you can die.

When to call an ambulance urgently

Dial 103, 112 or go to the nearest emergency room if you have these symptoms of appendicitis:

Drawing pain in the region of the navel or in the lower right part of the abdomen. Sometimes it can give to the thigh. In most cases, pain is the first sign of appendicitis.
Loss of appetite.
Weakness, lethargy.
Pale.
Nausea and vomiting. Sometimes they appear immediately, and sometimes a few hours after the onset of pain.
Cold sweat.
Bloating, difficulty passing gas.
Rapid heartbeat.
Temperature increase. Sometimes it can be insignificant – a little more than 37 ° C. Sometimes the fever jumps up to almost 39 °C.

What to do if you are in doubt whether it is appendicitis

If you have dangerous symptoms, but you feel tolerable and do not require an ambulance, double-check yourself using self-diagnosis techniques.

Cough. If it is appendicitis, the pain in the right side of the abdomen will increase.
Lying on the left side, lightly press the palm of your hand on the affected area, and then quickly remove your hand. With appendicitis, the pain will become stronger at this point.
Turn onto your left side and stretch your legs. With appendicitis, the pain will get worse.

However, it is important to understand that self-diagnosis must be treated critically. Monitor your condition. If symptoms suggestive of appendicitis become more severe, call an ambulance immediately or go to the emergency room. There is a high risk that it is still appendicitis and you will need urgent surgery.

What not to do before seeing a doctor

First of all, do not take painkillers, sorbents or any other drugs, do not give enemas. Due to self-treatment, the symptoms may change, it will be more difficult to determine appendicitis.

Second, you shouldn’t put pressure on your stomach and try to feel what’s wrong there. Due to the strong impact, the appendix can, roughly speaking, break through. This will lead to complications.

Where does appendicitis come from

Modern science is vague about why an appendix is needed. Some consider it a useless rudiment and reinforce this version by the fact that after its removal, as a rule, no health effects occur.

Others suggest that the appendix serves as a kind of repository of “good” bacteria, necessary to reset the intestinal microflora affected, for example, by diarrhea.

There are indeed many bacteria in the appendix. And they are often to blame for the development of appendicitis.

Kateryna Kon / Shutterstock

When the lumen of the appendix, which connects it to the caecum, narrows or closes for some reason, the number of bacteria in the process grows rapidly. This is how inflammation begins, that is, appendicitis.

Why the lumen of the appendix narrows is a complicated question. It is not always possible for doctors to answer it. But most often the cause is:

infections of the gastrointestinal tract and other abdominal organs;
chronic inflammatory bowel disease;
hardened stool accumulation;
parasites;
vascular problems;
neoplasms;
abdominal trauma.

What is the danger of appendicitis

If the inflamed appendix is not quickly removed or if careless pressure is applied to it, it may rupture. As a result, bacteria and pus that has accumulated in the appendix will enter the abdominal cavity and cause inflammation of its mucous membrane. This condition is called peritonitis, and it is deadly because it often causes blood poisoning.

Alexander J. Greenstein

MD, Surgeon at Mount Sinai Hospital, New York

It usually takes about a day from the onset of symptoms to a ruptured appendix. Therefore, it is essential to act quickly.

However, sometimes up to three days may elapse between the first symptoms and the rupture. But you should not delay calling an ambulance: it is not known how fast the process will go in your case.

Consider one more thing. Once the appendix ruptures, the pain may subside for a while. In no case do not trust this imaginary improvement in well-being. If you had symptoms of appendicitis, and then they seem to have passed by themselves, contacting the doctors is still necessary. There is a risk that the pain will return, and with peritonitis it is even worse.

In very rare cases, acute appendicitis becomes chronic. But at any time, this chronicle may again require urgent surgical intervention.

How to treat appendicitis

So far, the only effective treatment for appendicitis is removal of the appendix. This operation is called an appendectomy. It is performed under general anesthesia.

Of course, first the doctors will clarify whether it is really about appendicitis. To do this, you will have to pass several tests:

Physical examination . The surgeon will feel the site of potential inflammation to determine where the painful area is located.
Blood test . It will show the number of leukocytes – white blood cells that indicate an inflammatory process.
Urinalysis . It is needed to rule out other popular causes of abdominal pain, such as a urinary tract infection or kidney stones.
Hardware research . Most likely, you will have an ultrasound of the abdominal organs. Computed tomography (CT) or magnetic resonance imaging (MRI) may also be needed to confirm appendicitis or make another diagnosis.

The appendix is removed either through one large incision in the abdomen, 5-10 cm long (may leave a scar), or through several small ones (this type of operation is called laparoscopy, it leaves minimal marks on the skin). Before the operation, you will be asked to take an antibiotic to reduce the risk of bacterial complications.

After an appendectomy, you will have to spend several days in the hospital. And another 7 days or more will be spent on recovery.

You can return to school or work within a week after the operation, if it goes well. But the gym or other physical activities should be postponed for 2-4 weeks – the attending physician will name the specific date.

What to do to prevent appendicitis

Unfortunately, there is no way to prevent appendicitis. Only one link has been established: appendix inflammation is less common in people whose diet contains foods high in fiber – fresh vegetables and fruits, bran, whole grain bread, nuts, legumes.

Rebound test for appendicitis. Rebound Tenderness and Blumberg’s Sign: Understanding Peritonitis Diagnosis

Understanding Rebound Tenderness and Blumberg’s Sign

The Diagnostic Procedure

Common Symptoms Associated with Peritonitis

Underlying Causes of Peritonitis

Perforation and Abdominal Wall Breaches

Pelvic Inflammatory Disease (PID)

Complications from Medical Procedures

Liver Disease and Its Impact on Peritoneal Health

The Connection Between Cirrhosis and Peritonitis

Gastrointestinal Conditions Leading to Peritonitis

Appendicitis and Its Complications

Stomach Ulcers and Perforations

Pancreatitis and Its Consequences

Intestinal Disorders and Their Role in Peritonitis

Diverticulitis and Peritoneal Risk

The Importance of Timely Diagnosis and Treatment

Treatment Approaches for Peritonitis

Preventive Measures and Long-term Management

Rebound Tenderness and Blumberg’s Sign: Definition and Causes

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