Kehr's sign

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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 classical symptom of a ruptured spleen. May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ectopic pregnancy.

Kehr's sign is a classical example of referred pain: irritation of the diaphragm is signalled by the phrenic nerve as pain in the area above the collarbone.

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 or not he actually discovered it.[1]

See also


  1. Klimpel V (2004). "Does Kehr's sign derive from Hans Kehr? A critical commentary on its documentation?". Chirurg. 75 (1): 80–3. PMID 14740133.

nl:teken van Kehr