Aaron sign

Aaron sign is referred pain felt in the epigastrium upon continuous firm pressure over McBurney’s point, indicative of chronic appendicitis.

History of Aaron sign

Initially described in 1913 by Charles Dettie Aaron (1866-1951), an American gastroenterologist. Aaron published 4 clinical cases and his findings ‘to assist others in coming to some conclusion as to its value in the diagnosis of chronic appendicitis (appendicitis larvata)‘.

Chronic concealed appendicitis without active inflammation is difficult to diagnose. Ewald has well named this condition “appendicitis larvata.”

McBurney was the first to call our attention to the pain on pressure in the right inguinal region in acute appendicitis. This tender point may also be found in some eases of chronic appendicitis, though not in all. The referred distress or pain induced by continuous pressure over McBurney’s point seems to me to b a most valuable sign in arriving at the diagnosis chronic appendicitis.

I have been able to induce a referred pain or distress in the epigastrium, left hypochondrium, umbilical, left inguinal or precordial region by a continuous firm pressure over the appendix. I have found this test exceedingly valuable in deciding when and when not to recommend operation for chronic appendicitis

Aaron 1913

Associated Persons

• Charles Heber McBurney (1845-1913)
• Charles Dettie Aaron (1866-1951)

References

Historical articles

• Aaron CD. Diseases of the stomach with special reference to treatment. 1911
• Aaron CD. A sign indicative of chronic appendicitis. JAMA. 1913; 60(5): 350-351. [Aaron sign]
• Aaron CD. Diseases of the Digestive Organs with special reference to their diagnosis and treatment. 1918

Article reviews

• Eponymythology: Appendicitis eponymous signs. LITFL

Mike Cadogan

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |