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Abdominal Tenderness

February 15th, 2021
 
 
 
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Focal Abdominal Tenderness

Right hypochondrium - liver, gallbladder, stomach, hepatic flexure of colon, lungGallstones, peptic ulcer
Epigastrium - liver, gallbladder, stomach, transverse colon, pancreas, heartPancreatitis, peptic ulcer, reflux
Left hypochondrium - spleen, pancreas, stomach, splenic flexure of colon, lungPeptic ulcer, pancreatitis
Right lumbar - ascending colon, kidneyKidney stone, pyelonephritis
Umbilicus - small bowel, aortaPancreatitis, early appendicitis, peptic ulcer, IBD
Left lumbar - descending colon, kidneyKidney stone, diverticulitis, IBD
Right iliac fossa- appendix, terminal ileum, caecum, ovary, fallopian tube, ureterAppendicitis, caecal diverticulitis, ovarian pathology, ectopic pregnancy, PID, inguinal hernia
Hypogastrium - uterus, bladder, sigmoid colonCystitis, appendicitis, diverticulitis, IBD, uterine pathology
Left Iliac Fossa - sigmoid colon, ovary, fallopian tube, ureterSigmoid diverticulitis, ovarian pathology, ectopic pregnancy, PID, inguinal hernia

Generalised Abdominal Tenderness

  • Feel For

  • Generalised tenderness over more than one abdominal segment.
  • Significance

  • A feature of peritonism, suggestive of peritonitis.
  • Causes of Peritonitis

  • Infection post perforation - appendix, diverticulitis, IBD, perforated ulcer, surgical anastomosis
  • Spontaneous bacterial peritonitis (SBP)
  • Blood - endometriosis, ruptured ovarian cyst, trauma
  • Bile - post-surgical
  • Urine - pelvic trauma
  • Pancreatic fluid - pancreatitis
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