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Point tenderness - abdomen

Definition

Abdominal point tenderness refers to the pain you feel when pressure is applied to a specific part of the belly area (abdomen).

Alternative Names

Abdominal tenderness

Considerations

The abdomen is an area of the body a doctor can easily examine by touch. The doctor can feel masses and organs within the belly area and pinpoint where you feel pain.

Abdominal tenderness can range from mild to severe. "Rebound" tenderness occurs when the tissue that lines the abdominal cavity (the peritoneum) is irritated, inflamed, or infected. See:Peritonitis

Causes

• Abdominal abscess
• Appendicitis
• Certain types of hernias
• Diverticular disease
• Hepatitis
• Meckel's diverticulum
• Ovarian torsion (twisted Fallopian tube)
• Pelvic inflammatory disease

When to Contact a Medical Professional

Any person with point tenderness should call or present to an emergency room in order to be examined promptly by the health care provider!

Your health care provider will perform a physical exam, which includes gently pushing on areas of your abdomen. Persons with peritonitis will often tense the abdominal muscles when the area is touched by the doctor. This is called "guarding."

The doctor will note any point tenderness. This is a general term which means you have tenderness in a particular area.

For example, if you have appendicitis, you will likely have point tenderness when a specific part of your belly area is touched. This area is called McBurney's point.

The health care provider will also ask questions about your symptoms and medical history:

• When did the symptoms develop?
• Is this the first time you have had such discomfort?
• If not, when does the discomfort tend to occur?
• What other symptoms do you have? For example, do you have:
  • Constipation
  • Diarrhea
  • Fainting
  • Fever
  • Vomiting

The following tests may be done:

• Abdominal x-ray
• Abdominal CT scan (occasionally)
• Blood work, such as a complete blood count

In some cases, immediate surgery will be needed. This may involve an exploratory laparotomy or an emergency appendectomy.

Proctor DD. Approach to the patient with gastrointestinal disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 134.

Postier RG, Squires RA. Acute abdomen. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 45.

See also: Drugs associated with Acute Abdomen

Review Date: 11/16/2008
Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.