Answer
Tenderness medial to McBurney’s point suggesting a Meckel diverticulum should be distinguished from typical appendicitis tenderness. The presence of dilated loops of bowel by palpation or percussion is an important finding that should be sought along with the degree of tenderness associated with the distended bowel. If tenderness is appreciated in an area of the abdomen that is unusual or does not match the history, then gentle pinching of the abdominal muscles should be performed to determine whether the pathology is actually musculoskeletal rather than abdominal. Regardless of the initial findings, all 4 quadrants, with particular attention to the liver, spleen, and any areas of fullness or symptoms, should be sequentially examined and the findings recorded.
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Abdominal palpation of a boy.
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Abdominal auscultation.
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Abdominal auscultation.
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Percussion over the liver.
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Abdominal wall findings from a handlebar injury.
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Abdominal wall findings in a passenger who was restrained with only a lap belt during a motor vehicle accident.
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Location of McBurney point illustrated on the abdomen of a male subject.
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Abdominal quadrants.
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Grey Turner sign. This 40-year-old woman complained of worsening epigastric pain of five days' duration. On examination, she had hypotension, a board-like abdomen, and extensive ecchymoses over her right loin.
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Acute pancreatitis with Cullen sign.
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A person with jaundice due to hepatic failure.
