Why does my stomach hurt on the right side when I press on the left?

Rovsing's Sign: Right-Sided Pain with Left-Sided Palpation

The symptom you're describing—right lower quadrant pain when pressing on the left side of your abdomen—is called Rovsing's sign, and it is a classic indicator of acute appendicitis that requires immediate medical evaluation.

What This Sign Means

• Rovsing's sign occurs when palpation of the left lower quadrant causes pain in the right lower quadrant, suggesting peritoneal irritation from an inflamed appendix 1
• This happens because pressing on the left side pushes gas and fluid through the colon, which increases pressure in the cecum (where the appendix attaches) on the right side 1
• The presence of this sign significantly increases the likelihood of appendicitis and warrants urgent evaluation 1

Immediate Action Required

You should seek emergency medical care immediately because:

• Appendicitis can progress to perforation, which dramatically increases morbidity and mortality 1
• Early diagnosis is critical to prevent complications including abscess formation, peritonitis, and sepsis 1
• Delayed treatment increases the risk of serious disease-related complications 1

What to Expect During Evaluation

Clinical Assessment

• Your physician will perform a focused abdominal examination looking for additional signs of appendicitis 1
• Other findings that support appendicitis include rebound tenderness, guarding, and pain at McBurney's point (right lower quadrant) 1
• The history and physical examination contribute 73% to 94% of diagnostic information in evaluating abdominal symptoms 2

Imaging Studies

• CT of the abdomen and pelvis is the most useful examination for evaluating acute abdominal pain with a broad differential diagnosis 1
• CT is accurate regardless of patient sex or body habitus and guides appropriate management 1
• Intravenous contrast improves detection of bowel wall pathology, vascular issues, and fluid collections 1
• CT can detect complications such as perforation (indicated by extraluminal air) or abscess formation 1

Important Caveats

Alternative Diagnoses to Consider

While Rovsing's sign strongly suggests appendicitis, other conditions can cause similar symptoms:

• Diverticulitis (though typically causes left-sided pain, it can occasionally present atypically) 1
• Colitis or inflammatory bowel disease 1
• Bowel obstruction or hernia 1
• Gynecologic pathology in women (ovarian or fallopian tube conditions) 1
• Urolithiasis or pyelonephritis 1

Why Immediate Evaluation Matters

• Serious causes that require intervention are often apparent on initial evaluation 2
• Mortality rates increase significantly with complications like perforation and large amounts of extraluminal air 1
• Early imaging helps streamline patients to the appropriate treatment pathway, whether conservative management or surgical intervention 1

Do Not Delay

Do not wait to see if symptoms improve on their own. The presence of Rovsing's sign is a red flag that requires same-day emergency department evaluation 1. Call 911 or go directly to the nearest emergency department for assessment 1.