Which physical findings suggest appendicitis?

Updated: Jul 23, 2018
  • Author: Sandy Craig, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Physical examination findings include the following:

  • Rebound tenderness, pain on percussion, rigidity, and guarding: Most specific finding

  • RLQ tenderness: Present in 96% of patients, but nonspecific

  • Left lower quadrant (LLQ) tenderness: May be the major manifestation in patients with situs inversus or in patients with a lengthy appendix that extends into the LLQ

  • Male infants and children occasionally present with an inflamed hemiscrotum

  • In pregnant women, RLQ pain and tenderness dominate in the first trimester, but in the latter half of pregnancy, right upper quadrant (RUQ) or right flank pain may occur


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