Point tenderness - abdomen

The abdomen is an area of the body a health care provider can easily examine by touch. The provider can feel growths and organs in the belly area and find where you feel pain.

Abdominal tenderness can be mild to severe. Rebound tenderness means that there is more pain when pressure on the tender area is released. It occurs when the tissue that lines the abdominal cavity (the peritoneum) is irritated, inflamed, or infected. This is called peritonitis.

Causes include:

• Abdominal abscess
• Appendicitis
• Certain types of hernias
• Meckel diverticulum
• Ovarian torsion (twisted fallopian tube)

Get emergency medical help right away if you have abdominal point tenderness.

Your provider will examine you and gently push on places on your belly. People with peritonitis will often tense the abdominal muscles when the area is touched. This is called guarding.

The provider will note any point of tenderness. The location of the tenderness can indicate the problem that is causing it. For example, if you have appendicitis, you will have tenderness when a certain place in the lower right abdomen is touched. This spot is called McBurney point.

The provider will also ask questions about your symptoms and medical history. These may include:

• When did the symptoms start?
• Is this the first time you have had such discomfort?
• If not, when does the discomfort tend to occur?
• Are you having other symptoms, such as constipation, diarrhea, fainting, vomiting, or fever?

You may need to have the following tests:

• Abdominal x-ray
• Abdominal CT scan (occasionally)
• Abdominal ultrasound
• Blood work, such as a complete blood count

In some cases, you may need surgery right away. This may involve an exploratory laparotomy or an emergency appendectomy.

Abdominal tenderness

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 18.

Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 123.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.