Abdominal rigidity

Answer 1

Definition

Abdominal rigidity is stiffness of the muscles in the belly area, which can be felt when touched or pressed.

Alternative Names

Rigidity of the abdomen

Considerations

When there is a sore area in the abdomen, the pain becomes more intense as the hand presses against it and overcomes the muscular resistance.

A patient's fear or nervousness about being touched (palpated) in the abdominal area is referred to as voluntary rigidity. It usually occurs on both sides of the abdomen. Involuntary rigidity, usually caused by a physical condition, may affect one or both sides and may be associated with pain.

Nausea, vomiting, abdominal tenderness, swelling, and pain often accompany abdominal rigidity.

Common Causes

• Appendicitis
• Cholecystitis
• Gastrointestinal perforation
• Injury to the abdomen
• Peritonitis

Home Care

Involuntary abdominal rigidity should always be evaluated by your health care provider.

Call your health care provider if

All forms of involuntary rigidity and rebound tenderness (pain when the abdomen is gently pressed and then the pressure is suddenly released) require immediate medical attention, preferably in an emergency room. Surgery may be necessary.

What to expect at your health care provider's office

You will probably be seen in an emergency room rather than at your doctor's office.

The health care provider perform a physical examination. The physical examination may include a pelvic (and possibly a rectal) examination.

The health care provider will ask questions about your symptoms, such as:

• When did it first start?
• What other symptoms occur at the same time? For example, do you have abdominal pain?

Diagnostic tests that may be performed include the following:

• Barium studies of the stomach and intestines (such as an upper GI series)
• Blood tests
• Colonoscopy
• Gastroscopy
• Peritoneal lavage
• Stool studies
• Urine tests
• X-ray of the abdomen
• X-ray of the chest

You will probably not be given any pain relievers until a diagnosis is made. Pain relievers can hide your symptoms.

References

Proctor DD. Approach to the patient with gastrointestinal disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 134.

Postier RG, Squires RA. Acute abdomen. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 45.

Answer 2

Definition

Abdominal rigidity is stiffness of the muscles in the belly area, which can be felt when touched or pressed.

Alternative Names

Rigidity of the abdomen

Considerations

When there is a sore area inside the belly or abdomen, the pain will get worse when a hand presses against muscles of the abdomen.

Your fear or nervousness about being touched (palpated) may cause this symptom, but there should be no pain.

If you have pain when you are touched and you tighten the muscles to "guard" against more pain, it is more likely caused by a physical condition inside your body. The condition may affect one or both sides of your body.

Abdominal rigidity may occur along with:

• Abdominal tenderness
• Nausea
• Pain
• Swelling
• Vomiting

Common Causes

• Abscess inside the abdomen
• Appendicitis
• Cholecystitiscaused by gallstones
• Hole that develops through the entire wall of the stomach, small intestine, large bowel, or gallbladder (gastrointestinal perforation)
• Injury to the abdomen
• Peritonitis

Home Care

Involuntary abdominal rigidity should always be evaluated by your health care provider.

Call your health care provider if

All forms of involuntary rigidity and rebound tenderness (pain when the abdomen is gently pressed and then the pressure is released) need immediate medical attention, preferably in an emergency room. You may need surgery.

What to expect at your health care provider's office

You will probably be seen in an emergency room instead of at your doctor's office.

The health care providerwill perform a physical examination. The physical examination may include a pelvic (and possibly a rectal) examination.

The health care provider will ask questions about your symptoms, such as:

• When did they first start?
• What other symptoms do you have at the same time? For example, do you have abdominal pain?

Diagnostic tests that may be performed include:

• Barium studies of the stomach and intestines (such as an upper GI series)
• Blood tests
• Colonoscopy
• Gastroscopy
• Peritoneal lavage
• Stool studies
• Urine tests
• X-ray of the abdomen
• X-ray of the chest

You will probably not be given any pain relievers until a diagnosis is made. Pain relievers can hide your symptoms.

References

Bengiamin RN, Budhram GR, King KE, Wightman JM. Abdominal pain. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 21.

Postier RG, Squires RA. Acute abdomen. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 45.

Reviewed By

Review Date: 10/30/2010

Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.