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 The peritoneal cavity is a potential space between the parietal peritoneum (the peritoneum that surrounds the abdominal wall) and visceral peritoneum (the peritoneum that surrounds the internal organs). The parietal and visceral peritonea are lay ...

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 A splenic injury, which includes a ruptured spleen, is any injury to the spleen. The rupture of a normal spleen can be caused by trauma, such as a traffic collision. Signs and symptoms In minor injuries with little bleeding, there may be abdomin ...

. May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ruptured ectopic pregnancy. Kehr's sign is a classic example of

referred pain Referred pain, also called reflective pain, is pain perceived at a location other than the site of the painful stimulus. An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in th ...

: irritation of the

diaphragm Diaphragm may refer to: Anatomy * Thoracic diaphragm, a thin sheet of muscle between the thorax and the abdomen * Pelvic diaphragm or pelvic floor, a pelvic structure * Urogenital diaphragm or triangular ligament, a pelvic structure Other * Diap ...

is signaled by the

phrenic nerve The phrenic nerve is a mixed motor/sensory nerve which originates from the C3-C5 spinal nerves in the neck. The nerve is important for breathing because it provides exclusive motor control of the diaphragm, the primary muscle of respiration. In ...

as pain in the area above the

collarbone The clavicle, or collarbone, is a slender, S-shaped long bone approximately 6 inches (15 cm) long that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the right ...

. This is because the

supraclavicular nerves The supraclavicular nerves (descending branches) arise from the third and fourth cervical nerves. They emerge beneath the posterior border of the sternocleidomastoideus (sternocleidomastoid muscle), and descend in the posterior triangle of the neck ...

have the same

cervical nerves A spinal nerve is a mixed nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each side of the vertebral column. These are grouped into the ...

origin as the phrenic nerve, C3 and C4. The discovery of this is often attributed to a German

gall bladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, althoug ...

surgeon named Hans Kehr, but extensive studies into research he conducted during his life shows inconclusive evidence as to whether he actually discovered it.

References

Medical signs {{med-sign-stub

See also

References