What Is Kehr's Sign?

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  • Written By: Megan Shoop
  • Edited By: Michelle Arevalo
  • Last Modified Date: 13 October 2016
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Kehr’s sign is generally characterized as a sharp, sudden pain felt at the point of either shoulder. It may 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’s sign pain often originates somewhere in the abdomen. The pain travels through the nervous system instead of centering around the irritated area. Anyone experiencing Kehr’s sign should be taken to the hospital immediately. This kind of pain is usually associated with a ruptured spleen, a failed ectopic pregnancy, or serious irritation of one of the lower organs.

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


It may seem strange that distress in the lower half of the body could exhibit as pain in the shoulder, but even a surface 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 nerve systems that are attached to the organs in the lower body and to nerves in the muscles of the shoulders. Knowing this, it makes sense that any disruption occurring around the phrenic nerve could result in Kehr’s sign pain.

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

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


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