What is a positive Kehr sign indicative of?

Study for the PaEasy Emergency Medicine Test. Prepare with detailed questions and explanations. Get ready to ace your exam!

Multiple Choice

What is a positive Kehr sign indicative of?

Explanation:
Kehr sign is left shoulder pain resulting from irritation of the diaphragmatic peritoneum or its pleura by intraperitoneal blood. This usually points to splenic injury, such as splenic rupture, where blood accumulates under the left hemidiaphragm and stimulates the phrenic nerve (C3–5), sending referred pain to the left shoulder. In practice, a positive Kehr sign raises strong concern for spleen-related trauma or rupture. The other abdominal organs listed are not classically associated with this left shoulder referral pattern.

Kehr sign is left shoulder pain resulting from irritation of the diaphragmatic peritoneum or its pleura by intraperitoneal blood. This usually points to splenic injury, such as splenic rupture, where blood accumulates under the left hemidiaphragm and stimulates the phrenic nerve (C3–5), sending referred pain to the left shoulder. In practice, a positive Kehr sign raises strong concern for spleen-related trauma or rupture. The other abdominal organs listed are not classically associated with this left shoulder referral pattern.

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