Kehr's sign is associated with which condition?

Kehr's sign is associated with which condition?

• A. Ruptured spleen
• B. Pneumothorax
• C. Appendicitis
• D. Cholecystitis

Answer: (A)

Kehr's sign is left shoulder pain produced by irritation of the diaphragmatic peritoneum via the phrenic nerve. When blood accumulates in the peritoneal cavity from a splenic rupture, the left hemidiaphragm becomes irritated, and the referred pain is felt at the left shoulder tip (C4 dermatome). This makes ruptured spleen the classic association. Other conditions produce different pain patterns—appendicitis tends to cause lower right quadrant pain, cholecystitis causes right upper quadrant pain, and pneumothorax mainly presents with chest symptoms rather than this diaphragmaticly mediated shoulder pain.

Kehr's sign is left shoulder pain produced by irritation of the diaphragmatic peritoneum via the phrenic nerve. When blood accumulates in the peritoneal cavity from a splenic rupture, the left hemidiaphragm becomes irritated, and the referred pain is felt at the left shoulder tip (C4 dermatome). This makes ruptured spleen the classic association. Other conditions produce different pain patterns—appendicitis tends to cause lower right quadrant pain, cholecystitis causes right upper quadrant pain, and pneumothorax mainly presents with chest symptoms rather than this diaphragmaticly mediated shoulder pain.