Blumberg sign

Rebound tenderness test (Blumberg sign) is a clinical sign which may be elicited on physical examination and may be indicative of peritonitis. Deep palpation of the viscera over the suspected inflamed appendix followed by sudden release of the pressure causes the severe pain on the site

Initially described in 1907 by Jacob Moritz Blumberg (1873 – 1955), a German surgeon and gynaecologist. Blumberg believed that pain in the lower abdomen after abrupt withdrawal of the hand from the lower abdominal quadrant was a sign of appendicitis.

Blumberg believed that pain in the lower abdomen after abrupt withdrawal of the hand from the lower abdominal quadrant was a sign of appendicitis. Performed by gradually increasing the pressure of the palpating hand over the tender spot, and then removing abruptly. If the patient winces with pain upon withdrawal of the hand, the test is positive indicating a likelihood of peritonitis


Zunächst einen Druck auf die zu untersuchende Stelle des Abdomens auszuüben und den Patienten zu fragen, ob es schmerzt, dann nach erhaltener Antwort die palpierende Hand plötzlich abzuheben und nun sich von dem Patienten sagen zu lassen, ob im Moment des Abhebens es geschmerzt habe, resp welcher Schmerz grösser gewesen sei.

Die Methode lässt sich mit grösster Exaktheit anwenden, da es sich ja nicht um die Beurteilung der Grösse eines Schmerzes handelt, sondern um den Vergleich der Intensität zweier Schmerzen, und diese Angabe wird von den Patienten sehr zuverlässig gemacht.

1907; 54: 1177-1178

First of all exert pressure on the area of ​​the abdomen to be examined and ask the patient whether it hurts, then suddenly raise the palpating hand after receiving the answer and now let the patient tell you whether it hurt at the moment of lifting off or what pain was greater.

The method can be used with the greatest accuracy, since it is not a matter of assessing the size of one pain, but of comparing the intensity of two pain, and this information is very reliably given by the patient.

1907; 54: 1177-1178

1970: Prout determined that the demonstration of rebound tenderness suffers the twin disadvantages of being both unpleasant for the patient and of being diagnostically useless.

1991: The usefulness of the rebound tenderness test in indicating peritonitis was prospectively assessed in 142 unselected patients admitted as emergencies with abdominal pain and tenderness. It was found to be of no predictive value. [Sensitivity 0.81; Specificity 0.49]

Liddington Rebound tenderness test 1991

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Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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