Parietal or somatic abdominal pain is caused by irritation of fibers that innervate the parietal peritoneum, usually the portion covering the anterior abdominal wall. Because parietal afferent signals are sent from a specific area of peritoneum, parietal pain—in contrast to visceral pain—can be localized to the dermatome directly above the site of the painful stimulus. As the underlying disease process evolves, the symptoms of visceral pain give way to the signs of parietal pain, with tenderness and guarding. As localized peritonitis develops further, rigidity and "rebound" appear.
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