What is Kehr's sign indicative of?

Kehr's sign is indicative of referred pain that occurs in the left shoulder due to irritation of the diaphragm from blood that has accumulated in the peritoneal cavity, often as a result of splenic injury or trauma to the liver. The liver is closely associated with the diaphragm and the phrenic nerve, which innervates both the shoulder and diaphragm. When there is damage to the liver or spleen, the resulting blood can irritate the diaphragm, leading to pain that is felt in the shoulder region. This phenomenon is a classic clinical sign that helps healthcare providers identify potential abdominal injuries that may not present with straightforward symptoms directly at the site of trauma.

While the other options may relate to abdominal conditions and could cause various types of pain, they do not specifically correlate with the mechanism of referred pain associated with Kehr's sign. Rebound tenderness relates more to peritoneal irritation and is not specific to shoulder pain. Appendicitis pain is typically located in the right lower quadrant and does not refer to the shoulder. Gallbladder inflammation, or cholecystitis, usually presents with pain in the right upper quadrant rather than the left shoulder. Thus, identifying Kehr's sign as left shoulder pain due to liver trauma is crucial