Which signs are commonly associated with peritonitis in abdominal trauma?

• A. Rebound tenderness, guarding, rigidity, distention, decreased/absent bowel sounds, referred pain.
• B. Localized swelling without systemic signs.
• C. Elevated hemoglobin and thrombocytosis.
• D. Headache and dizziness.

Answer: (A)

The signs being tested are peritoneal irritation indicators. In abdominal trauma, irritation of the peritoneum typically produces somatic signs such as rebound tenderness, guarding (voluntary tensing to protect the abdomen), and rigidity (involuntary muscle guarding). Abdominal distention reflects accumulated gas or fluid from intra-abdominal injury, and decreased or absent bowel sounds indicate an ileus or compromised motility due to inflammation. Referred pain can occur when the peritoneum is irritated and pain is felt in areas away from the injured site. Together, these findings point to peritonitis from intra-abdominal injury and often signal the need for urgent evaluation and management.

Localized swelling without systemic signs lacks the widespread peritoneal involvement typical of peritonitis. Elevated hemoglobin and thrombocytosis are not characteristic signs of peritonitis in this context; peritonitis is more about peritoneal inflammation and systemic inflammatory response rather than those hematologic trends. Headache and dizziness are nonspecific and do not reflect intra-abdominal peritoneal irritation.