Massouh's sign is a clinical sign for acute localised
appendicitis
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ru ...
, named after General Surgeon Farouk Massouh from
Frimley Park Hospital
Frimley Park Hospital is a large general hospital in Frimley, Surrey. It is managed by Frimley Health NHS Foundation Trust, and houses a private wing.
History
Frimley Park Hospital was opened to provide a full range of acute services to pat ...
in
Frimley
Frimley is a town in the Borough of Surrey Heath in Surrey, England, approximately southwest of central London. The town is of Saxon origin, although it is not listed in Domesday Book of 1086.
Train services to Frimley (on the line between ...
(
Surrey, the United Kingdom).
The sign describes a firm swish of the examiner’s index and middle finger across the patient’s abdomen from xiphoid sternum to first the left and then the right iliac fossa. A positive Massouh sign is a grimace of the patient upon a right sided (and not left) sweep.
The explanation for the reliability of this diagnostic tool is based on the fact that appendicitis in the initial stage usually causes localised irritation of the peritoneum. The well innervated
peritoneum
The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of meso ...
is very sensitive to pain and therefore sensitive to jouncing movements. Similarly this is the explanation for other signs of localised peritonitis such as
Murphy's sign,
Rovsing's sign or
psoas sign
The psoas sign, also known as Cope's sign (or Cope's psoas test) or Obraztsova's sign, is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is re ...
.
There is currently no published evidence on the sensitivity or specificity of Massouh sign for suspected acute appendicitis.
References
{{Digestive system and abdomen symptoms and signs
Surgery