ABDOMINAL RIGIDITY
Ask the following questions:
- Is there tenderness and rebound tenderness? If this is absent, consider voluntary rigidity. If this is present, the finding must be considered serious.
- Is there a history of trauma? A history of trauma brings to mind the possibility of a ruptured spleen or other abdominal organ rupture or laceration.
- Is there a history of recurrent abdominal pain? This finding should make one think of a ruptured peptic ulcer or diverticulum or a perforated gallbladder, although appendicitis may occasionally be preceded by bouts of abdominal pain. If there is no history of trauma or abdominal pain, consider ruptured appendix, pelvic inflammatory disease (
PID
), ruptured ectopic pregnancy, peritonitis, pancreatitis, mesenteric, thrombosis, and ruptured abdominal aneurysm.
DIAGNOSTIC WORKUP
A stat CBC, urinalysis, chemistry panel, amylase and lipase, and flat plate and upright film of the abdomen should be done. Immediate consult with a general surgeon is in order. If surgery is to be delayed or when the exact cause of the rigidity is in doubt, consider ordering a chest x-ray to rule out pneumonia and a peritoneal tap to exclude ruptured ectopic pregnancy, generalized peritonitis, and laparoscopy. Blood cultures, abdominal ultrasound, and CT scans of the abdomen may be necessary to diagnose cholecystitis, diverticulitis, aortic aneurysm, and various neoplasms associated with rupture. Exploratory laparotomy must be considered in any case of unexplained tenderness and rigidity when the diagnosis is in doubt.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
Other Book Chapters Related to Abdominal rigidity in children
Read excerpts from these other book chapters related to Abdominal rigidity in children:
Medical Books Excerpts
- Abdominal rigidity
- "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
- [ read ]
Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.
More About Causes of Abdominal rigidity in children
» Next page: Abdominal rigidity [Abdominal muscle spasm, involuntary guarding] (Handbook of Signs & Symptoms (Third Edition))
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