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==Physical Examination technique==
==[[Rebound tenderness overview|Overview]]==
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]].


== Diagnosis ==
==[[Rebound tenderness historical perspective|Historical Perspective]]==
=== History and Symptoms ===  
* Location of pain, nature, intensity, onset, duration
* Guarding
* Past episodes
* Distention
* Bowel sounds
* Blood on rectal exam
* Presence of mass
* Cervical or adnexal tenderness
* Factors that alleviate pain
* Factors that aggravate pain
* Crampy, colicky pain occuring in waves (distention)
* Pain that is constant and localized in nature (inflammation)
* Shock
* Hypotension


== Laboratory Findings ==
==[[Rebound tenderness pathophysiology|Pathophysiology]]==
* [[Complete blood count]] (CBC)
* [[BUN]] ([[blood urea nitrogen]])/[[creatinine]]
* [[LFT]]s ([[liver function tests]])
* [[Pregnancy test]]
* [[Urinalysis]]
* [[Amylase]]/[[lipase]]


=== Electrolyte and Biomarker Studies ===
==[[Rebound tenderness causes|Causes]]==
* [[Electrolytes]]


=== X-Ray ===
==[[Rebound tenderness epidemiology and demographics|Epidemiology and Demographics]]==
* Obstruction, perforation or other pathologies revealed by abdominal X-ray.


=== Echocardiography or Ultrasound ===  
==Diagnosis==
* [[Ultrasound]] can test for the following:
[[Rebound tenderness history and symptoms|History and Symptoms]] | [[Rebound tenderness physical examination|Physical Examination]] | [[Rebound tenderness laboratory findings|Laboratory Findings]] | [[Rebound tenderness echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Rebound tenderness other imaging findings|Other Imaging Findings]] | [[Rebound tenderness other diagnostic studies|Other Diagnostic Studies]]
*:* [[Abdominal aortic aneurysm]]
*:* [[Ectopic pregnancy]]
*:* Biliary disorders
*:* [[Diverticulitis]]


=== Other Diagnostic Studies ===
==Treatment==
* Peritoneal lavage recommended for suspected trauma, peritonitis, or bowel perforation
[[Rebound tenderness medical therapy|Medical Therapy]] | [[Rebound tenderness surgery|Surgery]]
* Persistent [[vomiting]] and obstruction require a nasogastric tub


== Treatment ==
==Case Studies==
* Surgery
[[Rebound tenderness case study one|Case #1]]
* Immediately replace volume with saline and/or blood transfusion for those patients are are hemodynamically unstable
* Bowel rest for diverticulitis or bowel obstruction (possible colon resection)
== Pharmacotherapy ==


=== Acute Pharmacotherapies ===
{{Symptoms and signs}}  
* If intra-abdominal infection or perforated viscus is suspected, administer proper course of antibiotics
 
=== Indications for Surgery ===
* Life threatening emergencies such as; early sepsis or evidence of hemorrhage, require immediate surgical intervention
* Ruptured aneurysm, ectopic pregnancy, bowel perforation or ther pathologies require definite surgical repair.
 
== References ==
{{Reflist|2}}
 
{{Symptoms and signs}} }


[[Category:Physical examination]]
[[Category:Physical examination]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Surgery]]
[[Category:Surgery]]

Latest revision as of 19:09, 12 June 2015

Rebound tenderness Microchapters

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Overview

Historical Perspective

Pathophysiology

Causes

Epidemiology and Demographics

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Historical Perspective

Pathophysiology

Causes

Epidemiology and Demographics

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery

Case Studies

Case #1

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