Blumberg's sign (also referred to as rebound tenderness or Shchetkin–Blumberg's sign) is a clinical sign in which there is pain upon removal of pressure rather than application of pressure to the
abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
. (The latter is referred to simply as ''abdominal tenderness''.) It is indicative of
peritonitis
Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or ...
. It was named after German surgeon
Jacob Moritz Blumberg
Jacob Moritz Blumberg (27 June 1873 – 1955) was a German Jewish surgeon and gynaecologist and inventor and namesake of Blumberg's sign.
Life and work
Blumberg was born in the Province of Posen and educated at the University of Breslau (Wrocław) ...
.
Procedure
The
abdominal wall
In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls.
There is a common set of layers covering and forming all the walls: the deepest being the v ...
is compressed slowly and then rapidly released. A positive sign is indicated by presence of pain upon removal of pressure on the abdominal wall.
Clinical significance
The sign indicates aggravation of the
parietal peritoneum
The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesothe ...
by stretching or moving. Positive Blumberg's sign is indicative of
peritonitis
Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or ...
,
which can occur in diseases like
appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a rup ...
, and may occur in
ulcerative colitis
Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers of the colon and rectum. The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood (hematochezia). Weight loss, fever, and a ...
with rebound tenderness in the
right lower quadrant
The human abdomen is divided into quadrants and regions by anatomists and physicians for the purposes of study, diagnosis, and treatment. The division into four quadrants allows the localisation of pain and tenderness, scars, lumps, and other ...
.
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. Use of the sign has been supported by others.
See also
*
Abdominal exam
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
*
Murphy's sign
In medicine, Murphy's sign (also known as Sweeney’s sign) is a maneuver during a physical examination as part of the abdominal examination. It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in chole ...
*
Rovsing's sign
References
{{DEFAULTSORT:Blumberg Sign
Medical signs