McBurney's point is the point over the right side of the
abdomen
The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal ...
that is one-third of the distance from the
anterior superior iliac spine
The anterior superior iliac spine (ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the inguinal ligament, ...
to the
umbilicus (navel). This is near the most common location of the
appendix.
Location
McBurney's point is located one third of the distance from the right
anterior superior iliac spine
The anterior superior iliac spine (ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the inguinal ligament, ...
to the
umbilicus (navel).
This point roughly corresponds to the most common location of the base of the
appendix, where it is attached to the
cecum
The cecum ( caecum, ; plural ceca or caeca, ) is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix (a ...
.
Appendicitis
Deep
tenderness at McBurney's point, known as McBurney's sign, is a sign of
acute appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications o ...
.
The clinical sign of referred pain in the
epigastrium
In anatomy, the epigastrium (or epigastric region) is the upper central region of the abdomen. It is located between the costal margins and the subcostal plane. Pain may be referred to the epigastrium from damage to structures derived from the for ...
when pressure is applied is also known as
Aaron's sign. Specific localization of tenderness to McBurney's point indicates that inflammation is no longer limited to the lumen of the bowel (which localizes pain poorly), and is irritating the lining of the
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 mesotheli ...
at the place where the peritoneum comes into contact with the appendix.
Tenderness at McBurney's point suggests the evolution of acute appendicitis to a later stage, and thus, the increased likelihood of rupture. Other abdominal processes can also sometimes cause tenderness at McBurney's point.
Thus, this sign is highly useful but neither necessary nor sufficient to make a diagnosis of acute appendicitis.
The anatomical position of the appendix is highly variable (for example in retrocaecal appendix, an appendix behind the
caecum
The cecum ( caecum, ; plural ceca or caeca, ) is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix, ...
), which also limits the use of this sign, as many cases of appendicitis do not cause point tenderness at McBurney's point. For most open
appendectomies (as opposed to
laparoscopic
Laparoscopy () is an operation performed in the abdomen or human pelvis, pelvis using small Surgical incision, incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few ...
appendectomies), the incision is made at McBurney's point.
Pseudoaneurysm
A
pseudoaneurysm
A pseudoaneurysm, also known as a false aneurysm, is a locally contained hematoma outside an artery or the heart due to damage to the vessel wall. The injury passes through all three layers of the arterial wall, causing a leak, which is contai ...
in the
aorta
The aorta ( ; : aortas or aortae) is the main and largest artery in the human body, originating from the Ventricle (heart), left ventricle of the heart, branching upwards immediately after, and extending down to the abdomen, where it splits at ...
may be treated
surgically, with an incision made between McBurney's point and the lower
intercostal spaces
The intercostal space (ICS) is the anatomic space between two ribs (Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it.
Structures in intercostal space
* several kind ...
.
Peritoneal dialysis
McBurney's point may be a useful site for insertion of a
peritoneal dialysis
Peritoneal dialysis (PD) is a type of kidney dialysis, dialysis that uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is used to remove excess fluid, correct e ...
catheter
In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...
.
History
McBurney's point is named after
American surgeon
In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...
Charles McBurney (1845–1913).
McBurney himself did not locate his point in a precise way in his original article.
References
Bibliography
*
External links
{{Superficial axial anatomy
Diagnostic surgery
Medical signs