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Kehr's sign is a classic example of referred pain: irritation of the diaphragm is signaled by the phrenic nerve as pain in the area above the collarbone. This is because the supraclavicular nerves have the same cervical nerves origin as the phrenic nerve, C3, C4, and C5. [citation needed]
The major symptom and signs include an acute onset of RUQ abdominal pain aggravated by breathing, coughing or laughing, which may also present with referred pain to the right shoulder. There is usually also tenderness on palpation of the right upper abdomen and tenderness to percussion of the lower ribs which protect the liver.
Referred pain, also called reflective pain, [1] is pain perceived at a location other than the site of the painful stimulus.An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in the left side of neck, left shoulder, and back rather than in the thorax (chest), the site of the injury.
Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Other regions within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that the brain may interpret as arising from the shoulder. [1]
Pain arising from structures supplied by the phrenic nerve is often "referred" to other somatic regions served by spinal nerves C3-C5. For example, a subphrenic abscess beneath the right diaphragm might cause a patient to feel pain in the right shoulder. Irritation of the phrenic nerve (or the tissues it supplies) leads to the hiccup reflex.
Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. [1] Often gallbladder attacks (biliary colic) precede acute cholecystitis. [1] The pain lasts longer in cholecystitis than in a typical gallbladder attack. [1] Without appropriate treatment, recurrent episodes of cholecystitis are ...
In minor injuries with little bleeding, there may be abdominal pain, tenderness in the epigastrium and pain in the left flank. Often there is a sharp pain in the left shoulder, known as Kehr's sign. [1] In larger injuries with more extensive bleeding, signs of hypovolemic shock are most prominent.
Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm and the liver, visible on plain abdominal X-ray or chest X-ray. [1] Normally this causes no symptoms, and this is called Chilaiditi's sign. The sign can be permanently present, or ...