What it means
Shoulder pain felt because blood or irritation under the left side of the diaphragm stimulates a nerve that shares a pathway with the shoulder. It is a classic sign of a ruptured spleen, and it can occur with other bleeding into the abdomen, such as a ruptured ectopic pregnancy. Lying flat or raising the legs can bring it on. It is named after Hans Kehr, a German surgeon.
For the nurse
In a client with abdominal trauma, ask about shoulder pain and report it at once, with vital signs: it can mean internal bleeding.
At a glance
| Also written | Kehr's sign |
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Related terms
hemorrhage
A large loss of blood from a blood vessel, inside the body or out of it.
insufflation
Blowing a gas into a body cavity, such as carbon dioxide into the abdomen during laparoscopic surgery.