Parents have brought their 7-year-old child into the emergency room with abdominal pain. Which of the following clinical manifestations would lead the health care team to suspect the child has appendicitis? Select all that apply
A)
Tenderness in right lower quadrant with palpation
B)
Rebound tenderness in inguinal areas with palpation
C)
Redness and warmth over right lower quadrant
D)
Bloating and flatulence noticeable
E)
Urine has the smell of stool with brown coloring
Ans:
A, B
Feedback:
Appendicitis usually has an abrupt onset. Palpation of the abdomen usually reveals a deep tenderness in the LRQ, which is confined to a small area approximately the size of the fingertip. It usually is located at approximately the site of the inflamed appendix. Rebound tenderness, which is pain that occurs when pressure is applied to the area and then released, and spasm of the overlying abdominal muscles are common. An abscess may display redness and warmth. Bloating and flatulence are usually seen with diverticular disease as is the development of fistula (vesicosigmoid), where stool is seen in the urine.
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