Positive Murphy sign

MedGen UID:: 536979
•Concept ID:: C0240406
•: Finding

Synonyms:	Murphy sign positive; Murphy's sign; Murphy's sign positive; Sweeney's sign
SNOMED CT:	Murphy sign positive (300352008); Murphy's sign positive (300352008)

HPO:	HP:0034753

Definition

Murphy's sign is elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the subcostal region. In practice, Murphy's sign is performed by palpating the subcostal region during inspiration. If pain is elicited and the patient suddenly stops their inspiratory effort, a positive Murphy's sign has been elicited. [from HPO]

Term Hierarchy

GTR
MeSH

CClinical test, RResearch test, OOMIM, GGeneReviews, VClinVar

CROGVPositive Murphy sign

Disorder of digestive system
- Abnormality of the digestive system
  - Abnormality of digestive system physiology
    - Abdominal symptom
      - Positive Murphy sign

Professional guidelines

PubMed

Cholelithiasis: Presentation and Management.

Littlefield A, Lenahan C
J Midwifery Womens Health 2019 May;64(3):289-297. Epub 2019 Mar 25 doi: 10.1111/jmwh.12959. PMID: 30908805

The treatment of abdominoscrotal hydrocele: Is there a role for nonoperative management?

Khorasani M, Jamieson DH, Langer K, Murphy JJ
J Pediatr Surg 2016 May;51(5):815-8. Epub 2016 Feb 15 doi: 10.1016/j.jpedsurg.2016.02.029. PMID: 27261560

Clinical Presentation, Imaging, and Management of Acute Cholecystitis.

Katabathina VS, Zafar AM, Suri R
Tech Vasc Interv Radiol 2015 Dec;18(4):256-65. Epub 2015 Jul 16 doi: 10.1053/j.tvir.2015.07.009. PMID: 26615166

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Recent clinical studies

Etiology

Selective internal radiotherapy (SIRT) of hepatic tumors: how to deal with the cystic artery.

Theysohn JM, Müller S, Schlaak JF, Ertle J, Schlosser TW, Bockisch A, Lauenstein TC
Cardiovasc Intervent Radiol 2013 Aug;36(4):1015-22. Epub 2012 Sep 15 doi: 10.1007/s00270-012-0474-1. PMID: 22983697

A pulmonary embolism case presenting with upper abdominal and flank pain.

Unlüer EE, Denizbaşi A
Eur J Emerg Med 2003 Jun;10(2):135-8. doi: 10.1097/01.mej.0000072621.17469.c4. PMID: 12789072

Percutaneous transhepatic cholecystostomy: effective treatment of acute cholecystitis in high risk patients.

Berman M, Nudelman IL, Fuko Z, Madhala O, Neuman-Levin M, Lelcuk S
Isr Med Assoc J 2002 May;4(5):331-3. PMID: 12040818

See all (3)

Diagnosis

Gangliocytic Paraganglioma: A Rare Etiology of Obstructive Jaundice.

Alsaif HS, Hassan A, Refai OJ, Alyousef MJ, Alodaini AA, Almarhabi AA, Alghamdi HM
Am J Case Rep 2021 Jul 14;22:e931640. doi: 10.12659/AJCR.931640. PMID: 34257264 Free PMC Article

A huge gastric bezoar treated by traditional Chinese medicine purgative: A case report.

Dai Q, Jiang F
Medicine (Baltimore) 2018 Dec;97(50):e13712. doi: 10.1097/MD.0000000000013712. PMID: 30558089 Free PMC Article

Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital.

Hwang H, Marsh I, Doyle J
Can J Surg 2014 Jun;57(3):162-8. doi: 10.1503/cjs.027312. PMID: 24869607 Free PMC Article

Imaging the patient with right upper quadrant pain.

Nino-Murcia M, Jeffrey RB Jr
Semin Roentgenol 2001 Apr;36(2):81-91. doi: 10.1053/sroe.2001.22825. PMID: 11329660

The sonographic diagnosis of acute gangrenous cholecystitis: importance of the Murphy sign.

Simeone JF, Brink JA, Mueller PR, Compton C, Hahn PF, Saini S, Silverman SG, Tung G, Ferrucci JT
AJR Am J Roentgenol 1989 Feb;152(2):289-90. doi: 10.2214/ajr.152.2.289. PMID: 2643262

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