A young man in a motor vehicle accident shows signs of splenic injury. What is the expected physical finding?

When assessing a patient with a suspected splenic injury, rebound tenderness is often the expected physical finding. Rebound tenderness occurs when there is intra-abdominal irritation, usually due to bleeding or inflammation. The spleen is located in the left upper quadrant of the abdomen, and an injury there can lead to bleeding into the abdominal cavity, potentially resulting in peritonitis. When pressure is applied to the abdomen and then suddenly released, the pain experienced by the patient upon release indicates irritation of the peritoneum, a classic sign associated with visceral injuries, including splenic rupture.

In contrast, Murphy's sign is specific for cholecystitis (inflammation of the gallbladder) and involves pain during inspiration when the gallbladder is palpated. Bernard's sign is not commonly used in clinical practice in relation to abdominal injuries and is not associated with splenic issues. McBurney's point tenderness is specifically associated with appendicitis, located in the right lower quadrant of the abdomen, thus not applicable to splenic injuries.

Therefore, rebound tenderness is a crucial finding when evaluating mechanisms of intra-abdominal trauma, particularly in the setting of splenic injury.