Eponymous Signs In The Surgical Abdomen

Question 1

Rovsing’s sign - what is this?

Answer 1

This is when palpation of the left lower quadrant of a patient’s abdomen increases the pain felt in the right lower quadrant.
It is a sign of appendicitis.
This occurs as the peritoneal lining has become inflamed around the appendix thus irritating the muscles here; upon palpation of the left side the perineal lining is stretched and will produce pain where the peritoneum is irritating the muscle.
The patient may also display McBurney’s sign (deep tenderness on palpation of McBurney’s point), or Aaron’s sign (referred pain in the epigastrium upon deep palpation of the right lower quadrant).

Question 2

Boas’ sign - what is this?

Answer 2

This is hyperaesthesia (increased sensitivity) below the right scapula.
It may be a sign of acute cholecystitis, as the pain radiates through to the back, however this test is less than 10% sensitive.

Question 3

Boas sign is a sign of what condition?

Answer 3

This is hyperaesthesia (increased sensitivity) below the right scapula.
It may be a sign of acute cholecystitis, as the pain radiates through to the back, however this test is less than 10% sensitive.

Question 4

What sign is a sign of appendicitis?

Answer 4

Rovsing’s sign

This is when palpation of the left lower quadrant of a patient’s abdomen increases the pain felt in the right lower quadrant.
It is a sign of appendicitis.
This occurs as the peritoneal lining has become inflamed around the appendix thus irritating the muscles here; upon palpation of the left side the perineal lining is stretched and will produce pain where the peritoneum is irritating the muscle.

Question 5

Murphy’s sign - what is this? When is it seen?

Answer 5

This is pain when the patient inspires and holds a deep breath while the right subcostal area is palpation.
It is a sign of acute cholecystitis as the inflamed gallbladder comes into contact with the examiner’s hand.

Question 6

sign of acute cholecystitis as the inflamed gallbladder comes into contact with the examiner’s hand?

Answer 6

Murphy’s sign

This is pain when the patient inspires and holds a deep breath while the right subcostal area is palpation.
It is a sign of acute cholecystitis as the inflamed gallbladder comes into contact with the examiner’s hand.

Question 7

Cullen’s sign - what is this?

Answer 7

This is irregular purple-ish discolouration of the umbilical area due to intraperitoneal haemorrhage. The blood tracks along the gastrohepatic and falciform ligament to the umbilicus.
Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal intra-abdominal haemorrhage. Other examples include ruptured abdominal aortic aneurism or ectopic pregnancy.

Question 8

Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal intra-abdominal haemorrhage. Other examples include ruptured abdominal aortic aneurism or ectopic pregnancy.

What sign is this describing?

Answer 8

Cullen’s sign

This is irregular purple-ish discolouration of the umbilical area due to intraperitoneal haemorrhage. The blood tracks along the gastrohepatic and falciform ligament to the umbilicus.
Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal intra-abdominal haemorrhage. Other examples include ruptured abdominal aortic aneurism or ectopic pregnancy.

Question 9

… sign

This is bruising of the flanks area due to retroperitoneal haemorrhage.
Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal haemorrhage, for example ruptured abdominal aortic aneurism or blunt abdominal trauma.

Answer 9

Grey-Turner’s sign

This is bruising of the flanks area due to retroperitoneal haemorrhage.
Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal haemorrhage, for example ruptured abdominal aortic aneurism or blunt abdominal trauma.

Question 10

bruising of the flanks area due to retroperitoneal haemorrhage
Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal haemorrhage, for example ruptured abdominal aortic aneurism or blunt abdominal trauma.

What sign?

Answer 10

Grey-Turner’s sign

This is bruising of the flanks area due to retroperitoneal haemorrhage.
Commonly this is attributable to acute haemorrhagic pancreatitis, but it can be found with any retroperitoneal haemorrhage, for example ruptured abdominal aortic aneurism or blunt abdominal trauma.

Question 11

Name the two signs in the ‘surgical abdomen’

Answer 11

Cullens on left
Grey turners on the right

Cullen sign is a hemorrhagic discoloration of the umbilical area due to intraperitoneal hemorrhage from any cause; one of the more frequent causes is acute hemorrhagic panniculitis. Grey Turner sign is a discoloration of the left flank associated with acute hemorrhagic pancreatitis.