Kehr's sign indicates referred pain to which location?

Kehr's sign indicates referred pain to which location?

• A. Appendicitis
• B. Right shoulder
• C. Epigastric region
• D. Left shoulder

Answer: (D)

Kehr's sign is shoulder pain caused by irritation of the diaphragmatic peritoneum, most classically from blood in the peritoneal cavity after splenic injury. The phrenic nerve (C3–C5) carries sensory signals from the irritated diaphragm to the spinal cord, and the brain interprets those signals as pain in the shoulder region. Since the left diaphragm is affected by splenic sources, the referred pain lands in the left shoulder. This distinguishes it from other abdominal sources of pain, which don’t produce the characteristic left shoulder referral.

Kehr's sign is shoulder pain caused by irritation of the diaphragmatic peritoneum, most classically from blood in the peritoneal cavity after splenic injury. The phrenic nerve (C3–C5) carries sensory signals from the irritated diaphragm to the spinal cord, and the brain interprets those signals as pain in the shoulder region. Since the left diaphragm is affected by splenic sources, the referred pain lands in the left shoulder. This distinguishes it from other abdominal sources of pain, which don’t produce the characteristic left shoulder referral.