Dunphy sign [* cough test; coughing test ] increased abdominal pain, localised to the right lower quadrant, with coughing
Many different options for this one…
The most common derivation relates to one Osborne Joby Dunphy (1898–1989). However, I can find no reference to this individual, and no evidence of any publication relating to him or to his description of this sign.
John Englebert Dunphy (1908-1981) was an eminent American surgeon wrote in Physical Examination Of The Surgical Patient (in all four editions 1953-1975)
Pain elicited by coughing will be referred to the right lower quadrantDunphy 1953
Historically, Charles Heber McBurney (1845-1913) provided the first published documentation of the cough test in the diagnosis of appendicitis in 1891
…if firm pressure is made with the finger tip, and especially if the patient is made to cough while such pressure is being exerted, it is invariably easy to determine that the most sensitive point is a definite one in most cases.
Generally the patient complains if the right thigh is overextended, and he will object if he is asked to cough.McBurney 1891
- McBurney C. The Indications for Early Laparotomy in Appendicitis. Annals of Surgery. 1891; 13(4): 233–254.
- Dunphy JE. Examination of the Abdomen: Acute appendicitis. In: Physical Examination Of The Surgical Patient. 1953
- Lewis FR, Holcroft JW, Boey J, Dunphy E. Appendicitis: a critical review ofdiagnosis and treatment in 1000 cases. Arch Surg. 1975;110:677-684. [PMID 16566087]
- Bennett DH, Tambeur LJ, Campbell WB. Use of coughing test to diagnose peritonitis. BMJ. 1994 May 21;308(6940):1336. [PMC2540276]
- J. Englebert Dunphy: Surgical Icon. 2008
- Eponymythology: Appendicitis eponymous signs. LITFL
the person behind the name