Answer
Performing an abdominal examination in children is more challenging than in adults. A review article examining the published literature on diagnosing pediatric appendicitis failed to find a single study that documented that physical examination provided an acceptable level of sensitivity and specificity to arrive at a correct diagnosis. [8] The cardinal finding of right-lower quadrant pain predicts appendicitis more accurately in adults than in children. However, the authors still concluded that "clinical examination plays a key part in determining which children with abdominal pain should undergo immediate surgical consultation for appendectomy and which children should undergo further diagnostic evaluation, including diagnostic imaging." [8]
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Abdominal palpation of a boy.
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Abdominal auscultation.
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Abdominal auscultation.
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Percussion over the liver.
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Abdominal wall findings from a handlebar injury.
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Abdominal wall findings in a passenger who was restrained with only a lap belt during a motor vehicle accident.
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Location of McBurney point illustrated on the abdomen of a male subject.
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Abdominal quadrants.
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Grey Turner sign. This 40-year-old woman complained of worsening epigastric pain of five days' duration. On examination, she had hypotension, a board-like abdomen, and extensive ecchymoses over her right loin.
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Acute pancreatitis with Cullen sign.
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A person with jaundice due to hepatic failure.