At a series of points down the abdominal wall, gently pick up skin folds between finger and thumb without pinching the skin. Localized pain elicited in the RLQ may accompany appendicitis. Hook fingers under costal margins on the right. Have the patient take deep breath. Sharp increase in tenderness with sudden stop in inspiration is positive.
Positive sign is indicative of gall bladder disease.
Have the patient tighten abdominal muscles wall. Mass in abdominal wall remains palpable where as intra-abdominal mass will be obscured. All rights reserved.