Interactive Guide to Physical Examination
Evaluating patients with complaints of acute abdominal pain can be challenging. It is important to remember that both observation as well as serial abdominal exams over time may provide valuable information. Although not covered explicitly here, a rectal exam, genital or pelvic exam should also be performed when evaluating any patient with abdominal pain.
Before palpating the abdomen, ask the patient to try to localize the area of pain with one finger. If unable to do so, ask the patient to cough and see if there is localization of the pain with coughing. Alternatively, try lightly percussing the abdomen and determine if the pain can be localized with this maneuver. Localized pain is suggestive of peritoneal or intra-abdominal inflammation and is important information to have.
During palpation several examination techniques can be used to further assess for peritoneal or intra-abdominal inflammation. Rebound tenderness, the presence of the psoas sign, obturator sign, or Murphy's sign are all suggestive of peritoneal inflammation.
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Click on the video icon for an evaluation of the acute abdomen. |
