What is positive rebound tenderness?
When the physical exam is positive for rebound sensitivity, it means that the patient reports a sharp pain with the rapid release (ie, with the “rebound” of deep palpation).
How does a doctor check for rebound sensitivity?
To check for rebound sensitivity, a doctor applies pressure to an area of your abdomen with his hands. They quickly remove their hands and ask if they feel any pain when the skin and tissue that they pushed down comes back into place.
If you feel pain or discomfort, you have rebound sensitivity. If you don’t feel anything, your doctor can help rule out peritonitis as the cause of your symptoms.
What causes rebound tenderness?
Rebound tenderness is a sign of peritonitis, a serious condition that is an inflammation of the peritoneum. This inflammation is often the result of an infection.
Many things can cause the underlying infection, including:
Drilling. A hole or opening in the 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) is the consequence of an infection of the female reproductive organs, together with 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 the peritoneum to drain fluid during dialysis. An infection can occur if the tubes or the medical facility are not properly sterilized.
Liver disease scarring of liver tissue, known as cirrhosis, can cause ascites, which refers to the accumulation of fluid in the abdomen. If too much fluid builds up, it can cause a condition called spontaneous bacterial peritonitis.
A complication of surgery. Any type of surgery, even in the abdominal area, carries a risk of infection in the surgical wound.
Broken appendix. An infected or injured appendix can burst and spread bacteria to the abdomen. An abdominal infection can quickly turn into peritonitis if the ruptured appendix is not removed or treated right away.
Stomach ulcer. A stomach ulcer is a sore that can appear on the lining of the stomach. A certain type of ulcer known as a perforated peptic ulcer can create an opening in the lining of the stomach and cause an infection in the abdominal cavity.
Pancreatitis Inflammation or infection of your pancreas can spread to your abdominal cavity and cause peritonitis. Pancreatitis can also cause a fluid called chyle to leak from the lymph nodes into the abdomen. This is known as acute chylous ascites and can cause peritonitis.
Diverticulitis occurs when small bags in the intestines, called diverticula, become inflamed and infected. This can cause perforations in your digestive tract and make you vulnerable to peritonitis.
Abdominal injury Trauma or injury to the abdomen can damage the abdominal wall and make the peritoneum more susceptible to inflammation, infection, or other complications.
Use of rebound tenderness
To evaluate the possibility of appendicitis.
Client supine, knees/hips flexed; The therapist applies slow heaviness to the McBurney point and then rapidly releases
Severe pain when pressure is released usually in the presence of low fever and nausea indicates possible appendicitis and requires a referral.