What sign may indicate a ruptured spleen in a trauma patient?

Kehr's sign, which presents as referred pain in the left shoulder, is a classic indicator of a ruptured spleen, particularly in the context of abdominal trauma. This phenomenon occurs because of irritation of the diaphragm due to hemorrhage or fluid accumulation in the peritoneal cavity, which can irritate the phrenic nerve. The phrenic nerve supplies both the diaphragm and the shoulder region, leading to pain that is perceived in the shoulder area.

In trauma patients, a rupture of the spleen can lead to significant internal bleeding, and the resultant irritation of the diaphragm can manifest as Kehr's sign. Recognizing this sign is crucial in the context of trauma assessment, as it can indicate the need for urgent evaluation and potential surgical intervention.

Other signs and symptoms related to abdominal issues exist, but they are not specific to splenic injury. For instance, Murphy's sign refers to pain upon palpation of the gallbladder, often used in the assessment of cholecystitis, while Brudzinski's sign is associated with meningitis and indicates meningeal irritation. Cullen's sign, characterized by periumbilical ecchymosis, is more indicative of retroperitoneal bleeding and can be seen in various intra