Which finding best supports gastroenteritis over peritonitis in a patient with crampy abdominal pain and diarrhea and a soft abdomen?

• A. Rigid abdomen.
• B. Soft abdomen with cramping and diarrhea.
• C. Localized tenderness.
• D. Absent bowel sounds.

Answer: (B)

A soft abdomen with cramping and diarrhea points toward gastroenteritis because mucosal inflammation of the gut typically causes crampy pain and loose stools without peritoneal irritation. In gastroenteritis, the abdomen is usually nondistended and not tender to a guarding or rigid degree. Peritonitis, by contrast, irritates the peritoneum and tends to produce guarding with a rigid or board-like abdomen, often accompanied by rebound tenderness. While other signs like localized tenderness or absent bowel sounds can occur in various abdominal conditions, they are not as specific for differentiating gastroenteritis from peritonitis as the presence of a soft, non-rigid abdomen in the setting of diarrhea.