Carnett dan cough test

Carnett’s Sign
• Abdominal wall tenderness can be caused by trauma, abdominal wall
hematoma.
• The following technique, described by Carnett in 1926, may confirm
the abdominal wall as the source of the patient’s pain. The point of
maximal pain is identified, and this is palpated with the abdomen wall
relaxed and then tensed through the perfor- mance of a half sit-up
with the arms crossed.
• Increased pain with the wall tensed is a positive sign of abdominal
wall pathology
• decrease in pain is considered a negative test.
Cough Test
• Originally described by Rostovzev in 1909,
• this test seeks evidence of peritoneal irritation by having the patient cough.
• Jeddy and colleagues described a positive test as a cough causing a sharp,
localized pain.
• They applied this prospectively to patients with right lower quadrant pain
and found it to have near perfect sensitivity with a specificity of 95% for
the detection of appendicitis or peritonitis (one patient with perforated
diverticulitis).
• Bennett and colleagues consider signs of pain on coughing such as
flinching, gri- macing, or moving of hands to the abdomen as a positive test
and reported a sensitivity of 78% with a specificity of 79% for the detection
of peritonitis