Rebound tenderness is a type of abdominal pain found during a physical examination. It indicates various underlying conditions. This sign often points to potentially serious medical situations within the abdominal cavity that require prompt attention.
Understanding Rebound Tenderness
Rebound tenderness, also known as Blumberg’s sign, is pain that intensifies when pressure is quickly removed from the abdomen, rather than when pressure is applied. A healthcare professional elicits this by gently pressing on an area of the abdomen and then rapidly releasing the pressure. Pain upon release indicates rebound tenderness.
This occurs due to irritation or inflammation of the peritoneum, the thin membrane lining the abdominal cavity and covering the organs. When the abdominal wall is compressed, the inflamed peritoneum stretches. Releasing pressure causes the abdominal wall to quickly return, leading to sudden movement of the irritated peritoneal layers, which triggers sharp pain. Self-assessment is not recommended; a trained medical professional must perform this examination.
What Rebound Tenderness Indicates
Rebound tenderness is an indication of inflammation or irritation of the peritoneum, a condition known as peritonitis. The peritoneum has two layers: the visceral peritoneum, covering the organs, and the parietal peritoneum, lining the abdominal wall. While organs can cause discomfort, rebound tenderness specifically suggests that inflammation has extended to the parietal peritoneum, which is more sensitive to pain.
Peritonitis is a serious condition because the peritoneum acts as a protective barrier. When inflamed, often due to infection or fluid leakage from internal organs, it can lead to widespread inflammation throughout the abdominal cavity. This can cause severe complications, including sepsis (a life-threatening response to infection), and organ failure if not treated promptly. The presence of rebound tenderness signals an acute abdominal process that needs immediate investigation.
Common Conditions Where Rebound Tenderness Appears
Rebound tenderness appears in several acute abdominal conditions that cause peritoneal irritation. A common example is appendicitis, where inflammation of the appendix can lead to localized peritonitis, typically in the lower right abdomen. The pain of appendicitis often starts around the navel and then shifts to the lower right quadrant.
Diverticulitis, an inflammation of pouches in the colon, can also cause rebound tenderness, particularly if severe or if a diverticulum ruptures, leading to leakage into the abdominal cavity. This condition commonly presents with pain in the lower left abdomen. Another condition is cholecystitis, inflammation of the gallbladder, which can cause tenderness and rebound pain in the upper right abdomen.
A ruptured ectopic pregnancy, where a fertilized egg implants outside the uterus, can also cause significant abdominal pain and rebound tenderness due to blood or fluid irritating the peritoneum. This medical emergency can lead to rapid blood loss and shock. Peritonitis itself can also be a primary diagnosis or a complication of other conditions, manifesting with widespread abdominal tenderness and rebound.
When to Seek Urgent Medical Care
Rebound tenderness, or any severe abdominal pain, requires immediate medical evaluation. This sign often indicates a serious condition that can worsen rapidly without prompt treatment. Delaying medical attention can lead to severe complications, including widespread infection, organ damage, or be life-threatening.
When seeking medical care, provide healthcare professionals with detailed information about the pain: when it started, its location, severity, and any associated symptoms like fever, nausea, vomiting, or changes in bowel habits. Seek emergency medical help immediately for severe abdominal pain, especially if accompanied by fever, persistent vomiting, or symptoms of shock.