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| McBurney's point | |
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| Location of McBurney's point (1), located two thirds the distance from the umbilicus (2) to the anterior superior iliac spine (3). | |
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| Normal location of the appendix relative to other organs of the digestive system (anterior view). Cecum and appendix are visible at bottom left. |
McBurney's point is the name given to the point over the right side of the human abdomen that is one-third of the distance from the ASIS (anterior superior iliac spine) to the umbilicus (the belly button). This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.
The anterior cutaneous branch of iliohypogastric nerve is found near McBurney's point.[1]
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Clinical relevance
Deep tenderness at McBurney's point, known as McBurney's sign, is a sign of acute appendicitis.[2] The clinical sign of rebound pain when pressure is applied is also known as Aaron's sign. However almost every surgeon and doctor misquote 'McBurney's point as shown incorrectly in the diagram. Charles McBurney described a point in his original article about this subject in the Annals of Surgery. He described his point as being One inch from the anterior superior iliac spine (ASIS) on a line drawn from the ASIS to the umbilicus. The incision is four inches long one third above the line and two thirds below the line. This is so often misquoted that there are no surgical text books with the correct description in them (even Bailey and Love). Now that the Annals of Surgery are available on-line with a search facility all surgeons in training must look at his original article as it quotes the gridiron approach.
Specific localization of tenderness to McBurney's point indicates that inflammation is no longer limited to the lumen of the bowel (which localizes pain poorly), and is irritating the lining of the peritoneum at the place where the peritoneum comes into contact with the appendix. Tenderness at McBurney's point suggests the evolution of acute appendicitis to a later stage, and thus, the increased likelihood of rupture. Because the location of the appendix is often different in different people, and can migrate within the abdomen, many cases of appendicitis do not cause point tenderness at McBurney's point. Other abdominal processes can also sometimes cause tenderness at McBurney's point. Thus, this sign is highly useful but neither necessary nor sufficient to make a diagnosis of acute appendicitis. Also, the anatomical position of the appendix is highly variable (for example in retrocaecal appendix, an appendix behind the caecum), which also limits the use of this sign.
Eponym
The sign is named for Charles McBurney (surgeon), U.S. surgeon, 1845–1913. [3]
See also
References
- ^ Kyung Won, PhD. Chung (2005). Gross Anatomy (Board Review). Hagerstown, MD: Lippincott Williams & Wilkins, 255. ISBN 0-7817-5309-0.
- ^ "Definition: McBurney's sign from Online Medical Dictionary". Retrieved on 2007-12-06.
- ^ Charles McBurney (www.whonamedit.com)
External links
- Naraynsingh V, Ramdass MJ, Singh J, Singh-Rampaul R, Maharaj D (2003). "McBurney's point: are we missing it?". Surgical and radiologic anatomy : SRA 24 (6): 363–5. doi:. PMID 12652363.
Wikipedia content modification information:
- This page was last modified on 28 August 2008, at 13:09.
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