How is a Meckel diverticulum differentiated from appendicitis during an abdominal exam?

Updated: Dec 02, 2020
  • Author: Simon S Rabinowitz, MD, PhD, FAAP; Chief Editor: Kurt E Roberts, MD  more...
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Answer

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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