Sweeping sign

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The inverse sign ( engl. Kehr's sign ) is in the left shoulder radiating pain symptoms with accompanying hypersensitivity ( hyperesthesia ) of the skin, as a classic sign of a spleen or tubal rupture is valid, but also in other diseases, often with direct or indirect participation of the diaphragm (rupture of the diaphragmatic artery ( arteria phrenica ), gastric perforation , subphrenic ( sitting under the diaphragm ) abscess ). In a recumbent patient with suspected rupture of the spleen, the return sign can be better triggered by lowering the head. The Kehr symbol is an example of transmitted pain that is based on an incorrect assignment of a visceral sensation to a skin area ( dermatome ).

It is unclear whether the first description - as long suspected - actually goes back to the Berlin surgeon Hans Kehr (1862–1916).

See also

Saegesser sign

Individual evidence

  1. ^ Pschyrembel Clinical Dictionary . Founded by Willibald Pschyrembel. Edited by the publisher's dictionary editor under the direction of Helmut Hildebrandt. 261st edition. De Gruyter, Berlin 2007, ISBN 978-3-11-018534-8
  2. ↑ Christopher D. Sutton, Leslie-Jayne Marshall, Steve A. White, David P. Berry, Ashley R. Dennison: Kehr's sign - a rare cause: spontaneous phrenic artery rupture. In: ANZ Journal of Surgery. Vol. 72, No. 12, 2002, pp. 913-914, PMID 12523356 , doi : 10.1046 / j.1445-2197.2002.02339.x .
  3. ↑ Dante Allen Pappano, Ellen Sofia Bass: Referred shoulder pain preceding abdominal pain in a teenage girl with gastric perforation. In: Pediatric Emergency Care. Vol. 22, No. 12, 2006, pp. 807-809, PMID 17198213 , doi : 10.1097 / 01.pec.0000248691.19305.ec .
  4. ↑ Christopher G. Eden, TG Williams: Duodenal perforation after laparoscopic cholecystectomy. In: Endoscopy . Vol. 24, No. 9, 1992, pp. 790-792, PMID 1468400 , doi : 10.1055 / s-2007-1010586 .
  5. ↑ Oliver Kloeters, Michael W. Müller: Crash Course Surgery. Urban & Fischer, Munich et al. 2004, ISBN 3-437-43230-3 , p. 222.
  6. ↑ Volker Klimpel : Does the "Kehrschezeichen" come from Hans Kehr? In: surgeon. Vol. 75, 2004, pp. 80-83, PMID 14740133 , doi : 10.1007 / s00104-003-0796-2 .

further reading