What is Kehr's sign?

Kehr's sign is usually characterized as a sudden, sharp pain felt at the tip of either shoulder. It can be felt standing up, but patients usually find that the pain intensifies when they lie down and lift their feet. This happens because the source of Kehr sign pain often originates somewhere in the abdomen. The pain travels through the nervous system instead of being centered around the irritated area. Anyone experiencing Kehr's sign should be taken to hospital immediately. This type of pain is usually associated with a ruptured spleen, a failed ectopic pregnancy, or severe irritation of one of the lower organs.

German physician Hans Kehr is often credited with discovering Kehr's sign, giving this condition its name. Kehr was a gallbladder surgeon from Thuringia, Germany, who practiced medicine from the late 19th century to the early 20th century. Although this telltale stabbing pain is named after Kehr, historians speculate that the doctor only suspected the connection between shoulder pain and abdominal distress. He seems like he never proved his hypothesis, even though it turned out to be accurate.

It may seem strange that distress in the lower half of the body can exhibit as shoulder pain, but even a cursory understanding of the nervous system can explain this. The phrenic nerve is attached to several vertebrae located both above and below the waist. It also connects to several large nervous systems that are attached to organs in the lower body and to nerves in the shoulder muscles. Knowing this, it makes sense that any disruption that occurs around the phrenic nerve could cause Kehr sign pain.

People with this stabbing pain should describe exactly what they feel to their doctor, even if it seems unrelated to their shoulder pain. People with a ruptured spleen or gallbladder may also feel a burning sensation in the abdomen. This sensation is usually on the same side of the body as the painful shoulder.

Women should be aware of when their last menstrual period was and whether or not they are trying to get pregnant, as the Kehr sign may be evidence of an ectopic pregnancy. This occurs when an embryo begins to grow in the fallopian tube instead of the uterus. There is not enough room for the embryo to grow in the fallopian tube, often causing it to burst. This always ends in miscarriage, but it could also be extremely dangerous for the woman. The sooner she sees a doctor, the better chance she has of preserving her fertility and her life.

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