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In medicine, Murphy's sign (also known as Sweeney’s sign) is a maneuver during a physical examination as part of the abdominal examination. [1] It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.
This medical test was first described by the American surgeon John Benjamin Murphy in 1884. In the Post-Soviet states and Eastern Europe it is often called Pasternacki's sign after Belarusian internist Fiodor Ignatjevich Pasternacki, who described it during his rounds in a regional hospital in Minsk in 1888.
Transverse section, showing the relations of the capsule of the kidney. The costovertebral angle (Latin: arcus costovertebralis) is the acute angle formed on either side of the human back between the twelfth rib and the vertebral column.
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen.
Müller's sign at Who Named It? visible pulsation or bobbing of uvula: Murphy's punch sign: John B. Murphy: urology: perinephric abscess: Murphy's punch at Who Named It? punch tenderness at the costovertebral angle Murphy's sign: John B. Murphy: surgery: cholecystitis: Murphy's sign at Who Named It? hesitation on inspiration while gall bladder ...
Pain with deep inspiration leading to termination of the breath while pressing on the right upper quadrant of the abdomen usually causes severe pain (Murphy's sign). [15] Yellowing of the skin (jaundice) may occur but is often mild. Severe jaundice suggests another cause of symptoms such as choledocholithiasis. [14]
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Use of the sign has been supported by others. [5] [6] A study published in 2022 found that a positive Blumberg's sign made the diagnosis of acute appendicitis more likely, but that a negative sign did not rule out the diagnosis. In that sense, a positive Blumberg's sign serves as a tool to supplement clinical diagnosis. [7]