Murphy's sign
| Murphy's sign | |
|---|---|
| Purpose | upper right quadrant pain |
In
choledocholithiasis, pyelonephritis, and ascending cholangitis
.
During physical examination
Classically, Murphy's sign is tested for during an
diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is tender and, in moving downward, comes in contact with the examiner's fingers) and winces with a "catch" in breath, the test is considered positive. In order for the test to be considered positive, the same maneuver must not elicit pain when performed on the left side.[citation needed
]
Predictive value
Murphy's sign has a high
specificity is not high.[2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.[3]
History
The sign is named after American physician John Benjamin Murphy (1857–1916), a Chicago surgeon from the 1880s to the early 1900s, who first described the hypersensitivity to deep palpation in the subcostal area when a patient with gallbladder disease takes a deep breath.[citation needed]
See also
- gallstones.
- Murphy's triad
References
External links
- "Cholecystitis acute". Medcyclopaedia. GE. Archived from the original on 2012-02-05.