Kehr's sign

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.