ACUTE ABDOMINAL PAIN - Medicine for Mountaineering and Other Wilderness Activities - page 279

spotusuallyresultsintensingtheabdominalmuscles,whichcanblocksubsequentattempts
to detect subtle tenderness and muscle guarding. Gentle pressure at a site distant from the
suspected disorder may elicit pain referred to the site of inflammation and clarify the dia-
gnosis. A typical example is pressure in the left lower abdominal quadrant causing pain
in the right lower quadrant in cases of acute appendicitis ( Fig. 20-2 ) . Pain elicited when
pressure by the examining hand is released—rebound tenderness—is a sign of peritoneal
inflammation, which is usually caused by infection.
Figure 20-2. The four quadrants of the abdomen
Consultation