WordNet

place signs, as along a road; "sign an intersection"; "This road has been signed"
(medicine) any objective evidence of the presence of a disorder or disease; "there were no signs of asphyxiation"
a perceptible indication of something not immediately apparent (as a visible clue that something has happened); "he showed signs of strain"; "they welcomed the signs of spring" (同)mark
a character indicating a relation between quantities; "dont forget the minus sign"
a fundamental linguistic unit linking a signifier to that which is signified; "The bond between the signifier and the signified is arbitrary"--de Saussure
a gesture that is part of a sign language
a public display of a message; "he posted signs in all the shop windows"
engage by written agreement; "They signed two new pitchers for the next season" (同)contract, sign on, sign_up
approve and express assent, responsibility, or obligation; "All parties ratified the peace treaty"; "Have you signed your contract yet?" (同)ratify
communicate silently and non-verbally by signals or signs; "He signed his disapproval with a dismissive hand gesture"; "The diner signaled the waiters to bring the menu" (同)signal, signalize, signalise
mark with ones signature; write ones name (on); "She signed the letter and sent it off"; "Please sign here" (同)subscribe
be engaged by a written agreement; "He signed to play the casino on Dec. 18"; "The soprano signed to sing the new opera"
communicate in sign language; "I dont know how to sign, so I could not communicate with my deaf cousin"
having a handwritten signature; "a signed letter"

PrepTutorEJDIC

(ある事実・状態・感情などの)『表れ』,印,気配,徴侯(indication);(…の)こん跡,計跡《+『of』+『名』》・『身ぶり』,手まね,合図 / 『標識』,看板 / (数学・音楽などの)記号 / (…の)『象徴』,シンボル(symbol)《+『of』+『名』》・《文》(…の)『前兆』,きざし《+『of』+『名』》・宮(きゅう)(黄道12区分の一つ) ・〈手紙・書類・作品など〉‘に'『署名する』・(…に)〈名前など〉‘を'書く《+『名』+『on』(『to』)+『名』》 / …‘を'雇う契約に署名する・…‘を'合図する,知らせる;…に合図する・署名する・契約書に署名して雇われる
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Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/24 01:41:13」(JST)

wiki en

In medicine, Murphy's sign refers to a maneuver during a physical examination as part of the abdominal examination and a finding elicited in ultrasonography. 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.

During physical examination[edit]

Classically Murphy's sign is tested for during an abdominal examination; it is performed by asking the patient to breathe out and then gently placing the hand below the costal margin on the right side at the mid-clavicular line (the approximate location of the gallbladder). The patient is then instructed to inspire (breathe in). Normally, during inspiration, the abdominal contents are pushed downward as the diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is tender and, in moving downward, comes in contact with the examiner's fingers) and winces with a 'catch' in breath, the test is considered positive. In order for the test to be considered positive, the same maneuver must not elicit pain when performed on the left side. Ultrasound imaging can be used to ensure the hand is properly positioned over the gallbladder

Predictive value[edit]

Murphy's sign has a high sensitivity and negative predictive value; however, the specificity is not high.^[1] In the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.^[2]

History[edit]

The sign is named after American physician John Benjamin Murphy (1857–1916), a prominent Chicago surgeon from the 1880s through the early 1900s, who first described the hypersensitivity to deep palpation in the subcostal area when a patient with gallbladder disease takes a deep breath.

References[edit]

^ Singer AJ, McCracken G, Henry MC, Thode HC, Cabahug CJ (September 1996). "Correlation among clinical, laboratory, and hepatobiliary scanning findings in patients with suspected acute cholecystitis". Ann Emerg Med 28 (3): 267–72. doi:10.1016/S0196-0644(96)70024-0. PMID 8780468. Retrieved 2008-05-22.
^ Adedeji OA, McAdam WA (April 1996). "Murphy's sign, acute cholecystitis and elderly people". J R Coll Surg Edinb 41 (2): 88–9. PMID 8632396.

External links[edit]

"Cholecystitis acute". Medcyclopaedia. GE. Archived from the original on 2012-02-05.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 急性胆嚢炎：病因、臨床的特徴、および診断 acute cholecystitis pathogenesis clinical features and diagnosis
2. 救急外来における成人の腹痛の評価 evaluation of the adult with abdominal pain in the emergency department
3. 成人における合併症のない胆石症 uncomplicated gallstone disease in adults
4. 無石胆嚢炎 acalculous cholecystitis
5. 黄色肉芽腫性胆嚢炎 xanthogranulomatous cholecystitis

English Journal

JOURNAL CLUB: Gastric Band Slippage: A Case-Controlled Study Comparing New and Old Radiographic Signs of This Important Surgical Complication.

Swenson DW1, Pietryga JA, Grand DJ, Chang KJ, Murphy BL, Egglin TK.
AJR. American journal of roentgenology.AJR Am J Roentgenol.2014 Jul;203(1):10-6. doi: 10.2214/AJR.13.11650.
OBJECTIVE. The purpose of this study was to compare the diagnostic performance of four radiographic signs of gastric band slippage: abnormal phi angle, the "O sign," inferior displacement of the superolateral gastric band margin, and presence of an air-fluid level above the gastric band. MATERIALS A
PMID 24951191

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

Hwang H1, Marsh I2, Doyle J1.
Canadian journal of surgery. Journal canadien de chirurgie.Can J Surg.2014 Jun;57(3):162-8.
in

English, FrenchCONTEXTE: La cholécystite aiguë est l’une des maladies les plus répandues exigeant une chirurgie d’urgence. L’échographie est un test précis pour le dépistage de la cholélithiase, mais elle s’accompagne d’un taux élevé de diagnostics faux-négatifs de choléc

PMID 24869607

Bicuspid aortic valves: Diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT.

Murphy DJ1, McEvoy SH2, Iyengar S3, Feuchtner G4, Cury RC5, Roobottom C6, Baumueller S7, Alkadhi H8, Dodd JD9.
European journal of radiology.Eur J Radiol.2014 May 17. pii: S0720-048X(14)00246-0. doi: 10.1016/j.ejrad.2014.05.010. [Epub ahead of print]
OBJECTIVES: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves.MATERIALS AND METHODS: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly anal
PMID 24890084

Japanese Journal

胆道感染症の超音波診断をきわめる

岡庭信司,石井重登,岩下和広
超音波医学 42(3), 329-336, 2015
… 炎ガイドライン2013でも胆道感染症が疑われる全ての症例に対して初診時にまず超音波検査を行うべきとしている．急性胆嚢炎の診断には，胆嚢腫大，胆嚢壁肥厚，結石，デブリエコー，sonographic Murphy's signが有用である．一方，急性胆管炎には特異的な画像所見はないが，Charcotの3徴と胆道系酵素や炎症反応の上昇に加え，超音波検査にて胆管拡張あるいは結石や腫瘍といった閉塞機転が指摘されれ …
NAID 130005071357

胆道感染症の超音波診断をきわめる

岡庭信司,石井重登,岩下和広
超音波医学 advpub(0), 2015
… 炎ガイドライン2013でも胆道感染症が疑われる全ての症例に対して初診時にまず超音波検査を行うべきとしている．急性胆嚢炎の診断には，胆嚢腫大，胆嚢壁肥厚，結石，デブリエコー，sonographic Murphy's signが有用である．一方，急性胆管炎には特異的な画像所見はないが，Charcotの3徴と胆道系酵素や炎症反応の上昇に加え，超音波検査にて胆管拡張あるいは結石や腫瘍といった閉塞機転が指摘されれ …
NAID 130005063653