Examining an area of tenderness
Be very gentle while doing this. You may have to hurt your patient a little, but do this as gently as possible.
| AFRIKAANS | TRANSCRIPT | XHOSA |
|---|---|---|
| Well done. / Goed so! / Heke. | ||
| I’m going to check the spot you said was tender(sore). / Ek sal nou die gevoelige deel van u buik ondersoek. / Ndiza kukhangela le ndawo uthe ibuhlungu. | ||
| Please try and relax. / Ontspan asseblief. / Khawuzame ukuziyekelela. |
Exclude peritonism. This is the condition caused by irritation of the peritoneum, and usually indicates severe intra-abdominal pathology, such as a perforated viscus or severe infection.
The signs of peritonism are:
- Guarding
- Rebound tenderness
- Rigidity.
Even a slight bumping or shaking of the bed is often very painful with severe peritonism, and this is sometimes a useful trick when the genuineness of the pain is in doubt: distract the patient and bump the bed.
The third sign is rigidity, and indicates the severe peritoneal irritation. In this case, the abdominal muscles are, involuntarily, held contracted even without any pressure being applied to the abdomen, and is associated with severe pain.
Gently but firmly press your fingers into the abdomen, hold them there a second, and then sharply withdraw the hand. As the peritoneum rebounds, the muscles tighten and the patient indicates pain, which is usually severe.
