Niels Thorkild Rovsing

Niels Thorkild Rovsing (1862 – 1927) was a Danish surgeon

Principle work focused upon general surgery and urology. Eponymously linked with Rovsing sign (1907) to aid in the clinical diagnosis of acute appendicitis. Strong advocate for antisepsis and Listerism, and is a considered a pioneer in his field.

Published over 200 papers and gained international notoriety, particularly for his innovative urological surgery, primarily focused upon horseshoe and polycystic kidneys. In 1918 performed Male to female sex reassignment surgery, according to Rovsing, the first of its kind


Biography
  • Born on April 26, 1862 in Flensborg, Denmark
  • 1885 – M.D in from the University of Copenhagen, followed by a PHD from the same institution in 1889 entilted ‘About the etiology, pathogenesis and treatment of cystitis
  • 1892-1902 Practiced surgery at the Red Cross Hospital and Queen Louise Children’s Hospital, both in Copenhagen
  • 1902 – Professor of Surgery
  • 1904 – Director of Surgery at Royal Frederiks Hospital
  • 1908 – Founded Danish Surgical Society with Eilert Adam Tscherning (1851-1919)
  • 1910 – Campaigned for better surgical accommodation in Copenhagen, leading to opening of Rigshospitalet (University Hospital Copenhagen)
  • Honorary member of Edinburgh Medico-Chirurgical Society and the Association of Surgeons of Great Britain and Ireland
  • 1920 – Declined position of Prime Minister of Denmark, but accepted position as Minister of Education
  • Died on January 14, 1927 from cardiac failure and complications from X-ray therapy for laryngeal cancer,

Medical Eponyms
Rovsing Sign (1907)

The Rovsing sign is described variably in medical literature with most descriptions bearing little/no resemblance to the 1907 description by Rovsing, but rather the description offered by Perman in 1904.

This sign is commonly taught to be attributable to eliciting peritoneal irritation, Rovsing’s original description and intention were quite different. Rovsing originally described the manoeuvre as an attempt to distend the caecum and appendix by applying pressure to the left colon, in an anti-peristaltic fashion.

I press with my right hand onto the fingers of the left hand that is lying flat against the colon descendens [descending colon] and then let the hand glide up toward the splenic flexure…The entire method is based upon isolated rise of pressure within the colon.

Rovsing 1907

In doing this correctly, Rovsing suggests that if pain is elicited, then this isolates the source to the caecum or appendix, and rules out other structures in the right iliac fossa.

Rovsing sign BMJ 1956
Rovsing sign. Br Med J. 1956

2014Prosenz et al reviewed 1178 individual studies and found no included study correctly described the method of eliciting Rovsing sign. Of 9 textbooks reviewed, 3 English texts on surgery failed to described the sign accurately, however all 6 German (text)books provided an accurate description.

More eponyms
  • Rovsing Operation I (1910) procedure for decortication in polycystic kidney disease
  • Rovsing Syndrome (1911) umbilical pain in horseshoe kidney caused by vascular compression, enhanced by dorsal flexion of the lumbar vertebrae
  • Rovsing Operation II (1911) to separate a fused horseshoe kidney via division of the renal isthmus
  • Male to female sex reassignment surgery (1918) according to Rovsing, the first of its kind

Controversies

1890 Rovsing was dismissed from role as Junior Surgeon at Royal Frederiks Hospital when he married, as he was appointed as an ‘unmarried junior surgeon’. The dismissal received national attention, leading to other doctors striking, and five months later Rovsing was reinstated as a ‘married junior surgeon’.


Major Publications

References

Biography

Eponymous terms


Cite this article as: Mike Cadogan, "Niels Thorkild Rovsing," In: LITFL - Life in the FastLane, Accessed on August 11, 2022, https://litfl.com/niels-thorkild-rovsing/.

eponym

the person behind the name

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 |

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  1. Als Rovsing-Zeichen (nach Niels Thorkild Rovsing, dänischer Chirurg, 1862 bis 1927) bezeichnet man die bei einer Appendizitis („Blinddarmentzündung“) im Bereich des rechten Unterbauchs auslösbaren Schmerzen, die durch das rückwärts gerichtete Ausstreichen des Dickdarms (Colon) gegen den Uhrzeigersinn (zum Wurmfortsatz hin) entstehen. Das Auslösen des Rovsing-Zeichens ist nicht spezifisch für die Appendizitis, ebenso wenig wie die Nicht-Auslösbarkeit eine solche ausschließt. Das Zeichen ist daher nur im Kontext mit anderen klinischen Befunden zu verwerten.

    Aufgrund der Gefahr einer Verschlimmerung der Entzündung oder Perforation wird empfohlen, diesen Test nicht mehr durchzuführen.

    Perman-Zeichen nach schwedischem Chirurg Emil Perman 1856–1945. Schmerzen rechts Seitenbauch durch Palpation über links fossa illacta 1904.