• Symptom of Shchetkin-Blumberg

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    Blumberg symptom ( in the domestic literature Shchetkina - Blumberg) - this is a symptom by the names of the obstetrician who described him. Shchetkina, 1851-1923, and the German surgeon and midwife working in Odessa, J. M. Blumberg, 1873-1955).

    Symptoms of peritonitis: increased pain in the abdomen with rapid removal of the palpable hand from the abdominal wall after a slight pressure.

    To detect a symptom during palpation, the abdomen is slowly pressed with a hand( or an object, for example - a stethophonendoscope) onto the anterior abdominal wall. In this case, the patient notes a more or less pronounced soreness. If the pain in the abdomen sharply increases with the rapid removal of the palpable hand, the symptom is positive. If the character of the pain does not change when the hand is removed, the symptom is negative.

    Sometimes it is said that the symptom is "doubtful".This means that the patient experiences soreness or discomfort when relieving pressure on the anterior abdominal wall, but it is not sharp. This may also mean that the right tension of the muscles of the anterior abdominal wall( "dysphagia"), pronounced subcutaneous fat layer, ascites or abdominal distention interferes with the correct check of the symptom.

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    Positive symptom of Schetkin-Blumberg is due to irritation of the peritoneum and is most pronounced in peritonitis. With limited peritonitis, the symptom is of a local nature, for example, in patients with appendicitis it is defined in the right iliac region. When perforating the hollow organ and entering the free abdominal cavity of the contents of the gastrointestinal tract, the symptom is determined in all parts of the abdomen, which indicates a diffuse peritonitis. This symptom can occur with acute appendicitis, including.

    With a sharp strain of the muscles of the anterior abdominal wall( "dolce-like abdomen") and in the initial terms of peritonitis, the symptom may be questionable. Also, the symptom may be less pronounced in later terms of peritonitis due to degenerative changes in the nerve endings of the peritoneum. Sometimes the symptom may be positive in patients with uremia, pneumonia, myocardial infarction,( "pseudo-abdominal syndrome"), with hemoperitoneum, acute pancreatitis, anterior abdominal wall hematoma or retroperitoneal tissue.