ICD-10 R10.4 | ICD-9-CM 789.6 | |
Blumberg's sign, also referred to as rebound tenderness, is a clinical sign that is elicited during physical examination of a patient's abdomen by a doctor or other health care provider. It is indicative of peritonitis. It refers to pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.)
Contents
Procedure
The abdominal wall is compressed slowly and then rapidly released. A positive sign is indicated by presence of pain upon removal of pressure on the abdominal wall. It is very similar to rebound tenderness and might be regarded by some authors as the same thing, or at least a particular application of it.
Clinical significance
It represents aggravation of the parietal layer of peritoneum by stretching or moving.
Positive Blumberg sign or rebound tenderness is indicative of peritonitis which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant. This method is specially useful in diagnosing appendicitis requiring urgent management.
However, in recent years the value of rebound tenderness has been questioned, since it may not add any diagnostic value beyond the observation that the patient has severe tenderness. Use of the sign has been supported by others.
Etymology
It has been named after Jacob Moritz Blumberg (1873–1955), a German Jewish surgeon.