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Local signs of a traumatic spleen

"DOKS"
  • Debelt's sign
  • O'Connel's sign
  • Kehr's sign
  • Saegesser's sign

Or, "SKODa"


O'Connel's sign: It is Kehr's sign elicited with patient in Trendelenburg position. As it is usually becomes positive before the Kehr's sign, it is at times recommended to elicit O'Connel's sign as well.
Kehr's sign: Pain in the left shoulder caused by irritation of the undersurface of the diaphragm by blood leaking from a ruptured spleen. The pain impulses are referred along the phrenic nerve.
Saegesser's sign: Compression of phrenic point (along the border of the sternocleidomastoid muscle, 2-4 cm above the clavicle) causes sudden contraction of homolateral hemidiaphragm and severe pain along the lateral border of rectus abdominis muscle. It indicates a rupture or intracapsular bleeding of the spleen.

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