Which sign is described as increased abdominal pain with coughing, indicating appendicitis?

Which sign is described as increased abdominal pain with coughing, indicating appendicitis?

• A. Rovsing sign
• B. Dunphy sign
• C. Murphy sign
• D. Psoas sign

Answer: (B)

Pain that gets worse when the patient coughs is a sign of peritoneal irritation from appendiceal inflammation. Coughing increases intra-abdominal pressure, intensifying the pain over the inflamed area. This response is known as the Dunphy sign and is classically linked to appendicitis. Rovsing sign involves a different test—pain in the right lower quadrant when the left lower quadrant is palpated, which indicates peritoneal irritation but not specifically coughing. Murphy sign points to gallbladder disease and is elicited by a painful inspiratory pause during palpation of the right upper quadrant. Psoas sign appears with irritation of the iliopsoas muscle, typically from a retrocecal appendix, and shows pain with hip extension or resisted hip flexion.

Pain that gets worse when the patient coughs is a sign of peritoneal irritation from appendiceal inflammation. Coughing increases intra-abdominal pressure, intensifying the pain over the inflamed area. This response is known as the Dunphy sign and is classically linked to appendicitis.

Rovsing sign involves a different test—pain in the right lower quadrant when the left lower quadrant is palpated, which indicates peritoneal irritation but not specifically coughing. Murphy sign points to gallbladder disease and is elicited by a painful inspiratory pause during palpation of the right upper quadrant. Psoas sign appears with irritation of the iliopsoas muscle, typically from a retrocecal appendix, and shows pain with hip extension or resisted hip flexion.