Blumberg sign

Blumberg's sign (also referred to as rebound tenderness, Shyotkin-Blumberg sign) is a clinical sign that is elicited during physical examination of a patient's abdomen by a doctor or other health care provider. It is indicative of peritonitis. 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.)

Rebound tenderness
Medical diagnostics
ICD-10-PCSR10.4
ICD-9-CM789.6

Procedure

The abdominal wall is compressed slowly and then rapidly released. A positive sign is indicated by presence of pain upon removal of pressure on the abdominal wall. It is very similar to rebound tenderness and might be regarded by some authors as the same thing, or at least a particular application of it.

Clinical significance

It represents aggravation of the parietal layer of peritoneum by stretching or moving.

Positive Blumberg sign or rebound tenderness is indicative of peritonitis[1] which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant. This method is specially useful in diagnosing appendicitis requiring urgent management.

However, in recent years the value of rebound tenderness has been questioned, since it may not add any diagnostic value beyond the observation that the patient has severe tenderness.[2] Use of the sign has been supported by others.[3][4]

Etymology

It has been named after Jacob Moritz Blumberg (1873–1955), a German surgeon.[5][6]

See also

References
  1. Dale Berg (14 May 2004). Advanced clinical skills and physical diagnosis. Wiley-Blackwell. pp. 119–. ISBN 978-1-4051-0433-3. Retrieved 26 October 2010.
  2. Liddington MI, Thomson WHF. Rebound tenderness test. British Journal of Surgery, 1991, 78: 795–796
  3. Bundy, DG.; Byerley, JS.; Liles, EA.; Perrin, EM.; Katznelson, J.; Rice, HE. (July 2007). "Does this child have appendicitis?". JAMA. 298 (4): 438–51. doi:10.1001/jama.298.4.438. PMC 2703737. PMID 17652298.
  4. Golledge, J.; Toms, AP.; Franklin, IJ.; Scriven, MW.; Galland, RB. (January 1996). "Assessment of peritonism in appendicitis". Ann R Coll Surg Engl. 78 (1): 11–4. PMC 2502643. PMID 8659965.
  5. synd/2449 at Who Named It?
  6. J. M. Blumberg. Ein neues diagnostisches Symptom bei Appendicitis. Münchener medizinische Wochenschrift, 1907, 54: 1177-1178.


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