Abdominal tenderness

Introduction Abdominal tenderness The pain that occurs when the abdomen is pressed from shallow to deep. The site of tenderness is often the lesion: 1 right upper abdomen tenderness, seen in liver, gallbladder, colonic hepatic flexion, ascending colon and kidney lesions. 2 upper abdominal tenderness, found in the stomach, duodenum, liver, gallbladder, pancreas and transverse colon and other diseases. 2 left upper abdomen tenderness, see ten spleen, pancreatic tail, left kidney, colon spleen and descending colon lesions.

Cause

Etiology classification

The site of tenderness is often the lesion:

1 right upper abdomen tenderness, seen in liver, gallbladder, colonic hepatic flexion, ascending colon and kidney lesions.

2 upper abdominal tenderness, found in the stomach, duodenum, liver, gallbladder, pancreas and transverse colon and other diseases.

2 left upper abdomen tenderness, see ten spleen, pancreatic tail, left kidney, colon spleen and descending colon lesions.

4 right waist tenderness, mostly caused by kidney and ascending colon lesions.

5 umbilical abdominal tenderness, seen in small bowel lesions, such as enteritis, intestinal parasitic diseases.

8 left lumbar tenderness, seen in the left kidney and descending colon lesions.

7 right lower abdomen tenderness, more common in appendicitis, can also be caused by ileocecal or right fallopian tube disease.

8 lower abdominal tenderness, seen in bladder and female genital lesions.

9 left lower abdomen tenderness, seen in the sigmoid colon and left fallopian tube lesions.

In addition, abdominal extra-abdominal lesions such as pneumonia, pleural lesions, myocardial infarction, etc. can also produce abdominal tenderness, should be noted.

an examination

Related inspection

Fiberoptic endoscopy for abdominal vascular ultrasound

1, fiber gastroscopy: fiber gastroscope with a soft body, easy to operate, less patient pain, safer, wide range of indications, no blind spots and so on.

2, palpation of the abdomen: When tenderness occurs, the finger stops for a while in the original place, so that the tenderness tends to be stable, and then the hand is lifted quickly. If the examinee feels that the abdominal pain suddenly increases and is accompanied by a painful expression or embarrassment, it is called The rebound pain is a sign that the peritoneal wall layer is affected by inflammation. It is found in the intra-abdominal organ lesion involving the adjacent peritoneum.

Differential diagnosis

Identification:

Anti-jumping pain: Slowly press down on the abdomen with your fingers. When tenderness occurs (or no tenderness), the finger stops for a while, then quickly removes the finger and feels the original abdominal pain increases or severe pain. For inflammation, the signs of the peritoneal wall layer are involved. It is more common in primary peritonitis when the intra-abdominal organ lesions involve the adjacent peritoneum.

diagnosis:

1. The tenderness caused by abdominal wall lesions is obvious when grasping the abdominal wall or lifting the shoulder on the back.

2. The tenderness caused by intra-abdominal lesions can be caused by inflammation of the organs, congestion, tumors, rupture, torsion, and stimulation of the peritoneum.

3. Common tender points in the abdomen:

1 The gallbladder point tenderness at the junction of the right rectus abdominis and the costal margin marks gallbladder lesions.

2 McBurney point tenderness at the junction of the umbilical cord and the right upper anterior superior iliac spine line at the junction of the anterior superior iliac crest suggests a appendix lesion.

The 2nd rib point (pre-kidney point) is located at the front end of the 10th rib and is the location of the renal pelvis.

4 The upper ureteral point is on the outer edge of the rectus abdominis on the umbilical level.

5 The ureteral point is on the outer edge of the rectus abdominis on the horizontal line of the anterior superior iliac spine, which is equivalent to the second stenosis of the ureter.

The rib ridge point is located at the apex of the 12th rib and the transverse process of the spine, also called the rib angle, which is the position of the kidney.

7 waist points. At the time of palpation, the index finger of the right hand and the finger of the middle finger were placed on the abdominal wall and gradually deepened.

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