The Curbsiders Internal Medicine Podcast #261 Acute Abdominal Pain: Physical Exam Series
Mar 15, 2021
Dr. Andrew Olson, an associate professor at the University of Minnesota, brings his expertise in clinical diagnostics to the discussion. He emphasizes the pivotal role of a thorough physical examination in diagnosing acute abdominal pain, sharing evidence-based insights. Topics include when to call a surgeon, the effectiveness of traditional maneuvers, and the importance of distinguishing serious conditions through careful assessment. Dr. Olson also highlights the balance between intuition and evidence in making accurate diagnoses, making it a must-listen for medical professionals.
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Exam as Diagnostic Probability Tool
- Abdominal physical exams serve to adjust the probability of diseases and guide testing or treatment.
- This helps decide if the patient is above the treatment or below the testing threshold.
Identify Peritonitis Through Rigidity
- Look for peritonitis signs like rigidity to identify patients needing urgent surgery.
- Focus on involuntary abdominal muscle contraction that signals parietal peritoneum inflammation.
Gentle Palpation Over Rebound Tenderness
- Use gentle, progressive palpation starting away from the painful area to assess abdomen properly.
- Avoid rebound tenderness when possible as it causes intense pain; prefer percussion tenderness for peritoneal inflammation.