The role of rebound tenderness in acute appendicitis and appendicular perforation

Authors

  • Yashwant R. Lamture Department of Surgery, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India
  • Varsha P. Gajbhiye Department of Surgery, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20170221

Keywords:

Appendicitis, Perforation, Peritonitis

Abstract

Background: Acute appendicitis is the most common surgical emergency. Inspite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, rebound tenderness is very important sign with controversial views regarding it in available literature. Hence this study was undertaken to prove its efficacy of it related to rule out appendicular perforations.

Methods: This study was conducted in 418 patients with 186 female and 251 male. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by data statistic software.

Results: The sensitivity and specificity of rebound tenderness to diagnose acute appendicitis is 65% and 73.6% respectively whereas the sensitivity and specificity of rebound tenderness to diagnose appendicular perforation was 94% and23.3% respectively with positive predictive value is 5 and negative predictive value is 99.

Conclusions: Hence it indicates that rebound tenderness is very important to rule out complications like perforation or peritonitis and to support diagnosis of acute appendicitis. It has minimal significance to diagnose perforation of appendix as positive predictive value is less.

References

Marudanayagam R, Williams GT, Rees BI. Review of the pathological results of 2660 appendicectomy specimens. J Gastroenterol. 2006;41:745-9.

Hussain A, Mahmood H, Singhal T, Balakrishnan S, Hasani S. What is positive appendicitis? a new answer to an old question. Clinical, macroscopical and microscopical findingsin 200 consecutive appendectomies. Singapore Med J. 2009;50(12):1145.

Berg D. Advanced clinical skills and physical diagnosis. 2nd edition. Wiley-Blackwell. 2004:119.

Liddington MI, Thomson WHF. Rebound tenderness test. British J Surg. 1991;78:795-6.

Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice, HE. Does this child have appendicitis? JAMA. 2007;298(4):438-51.

Alshehri MY, Ibrahim A, Abuaisha N, Malatani T, Eshy AS, Khairulla S, Bahamdan K. Value of rebound tenderness in acute appendicitis. East Afr Med J. 1995;72(8):504-6.

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Published

2017-01-25

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Section

Original Research Articles