Cause of rebound tenderness

[mhco]

Hi,

I am confused as to the exact mechanics of rebound tenderness.

I know rebound tenderness refers to pain upon removal of pressure rather than application of pressure to the abdomen, and is due to peritonitis.

However, if the peritoneum is inflammed, why does putting pressure on it (eg by pressing on the abdomen) not cause pain, whereas removing pressure from it, does cause pain?

Surely both applying & removing pressure cause peritoneal irrittation and therefore pain?

Thank you in advance for your help.

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[Beezlebub]

Hi,

I am confused as to the exact mechanics of rebound tenderness.

I know rebound tenderness refers to pain upon removal of pressure rather than application of pressure to the abdomen, and is due to peritonitis.

However, if the peritoneum is inflammed, why does putting pressure on it (eg by pressing on the abdomen) not cause pain, whereas removing pressure from it, does cause pain?

Surely both applying & removing pressure cause peritoneal irrittation and therefore pain?

Thank you in advance for your help.

It could potentially cause pain if the region you apply pressure upon is tender ("abdominal tenderness"). However, the purpose of rebound tenderness, as you correctly stated above, is to target other areas (not the area where you apply pressure upon) by quickly removing the pressure stimulus and causing an irritant effect to other parts of the peritoneum. Think of it as a pressure wave dispersing around the peritoneal cavity. This will rule out if a patient has peritonitis or other acute abdomen condition.