Site location: McBurney's point
Steps:
(1) Gently grip and lift a 2-3 inch fold of skin until some recoil is felt.
(2) Release the fold rapidly.
If the pain during step 2 is greater than in step 1, then the test is positive.
If the pain in step 1 is greater than in step 2, then the test is negative.
If both are equivalent, then the test is indeterminate.
Interpretation:
• A positive test is suggestive of peritonitis.
• Significant pain during step 1 may indicate a low tolerance for pain.
Implementation points:
• A maximal pain that is minimal would make interpretation difficult.
• The test may not be beneficial if there is severe or extreme pain, since this would indicate significant disease.
• Reporting significant pain during step 1 may also be a sign of malingering.
