Kehr's sign

2024-04-29T20:04:08Z

131.111.5.165: Corrected the spinal origin of the phrenic nerve

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'''Kehr's sign''' is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the [[peritoneal cavity]] when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classic symptom of a [[ruptured spleen]].<ref>{{cite journal | pmid = 655846 | volume=113 | issue=6 | title=Rupture of the spleen in infectious mononucleosis: a critical review |date=June 1978 | author=Rutkow IM | journal=Arch Surg | pages=718–20 | doi=10.1001/archsurg.1978.01370180060007}}</ref><ref name="Openstax Anatomy & Physiology attribution">{{cite book|last1=Betts|first1=J Gordon|last2=Desaix|first2=Peter|last3=Johnson|first3=Eddie|last4=Johnson|first4=Jody E|last5=Korol|first5=Oksana|last6=Kruse|first6=Dean|last7=Poe|first7=Brandon|last8=Wise|first8=James|last9=Womble|first9=Mark D|last10=Young|first10=Kelly A|title=Anatomy & Physiology|url=https://openstax.org/books/anatomy-and-physiology/pages/15-2-autonomic-reflexes-and-homeostasis|location=Houston|publisher=OpenStax CNX|isbn=978-1-947172-04-3|date=June 8, 2023|at=15.2 Autonomic reflexes and homeostasis}}</ref> May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ruptured ectopic pregnancy.{{cn|date=July 2022}}

Kehr's sign is a classic example of [[referred pain]]: irritation of the [[Diaphragm (anatomy)|diaphragm]] is signaled by the [[phrenic nerve]] as pain in the area above the [[collarbone]]. This is because the [[supraclavicular nerves]] have the same [[cervical nerves]] origin as the phrenic nerve, C3, C4, and C5.{{cn|date=July 2022}}

The discovery of this is often attributed to a German [[gall bladder]] surgeon named [[Hans Kehr]], but extensive studies into research he conducted during his life shows inconclusive evidence as to whether he actually discovered it.<ref>{{cite journal | author = Klimpel V | title = Does Kehr's sign derive from Hans Kehr? A critical commentary on its documentation? | journal = Der Chirurg | volume = 75 | issue = 1 | pages = 80–3 | year = 2004 | pmid = 14740133 | doi = 10.1007/s00104-003-0796-2| s2cid = 22705413 }}</ref>

==See also==
* [[Ruptured spleen]]

==References==
<References />

{{Eponymous medical signs for respiratory system}}
{{Digestive system and abdomen symptoms and signs}}

[[Category:Medical signs]]

{{med-sign-stub}}

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Kehr's sign