This presentation gives answer to the question regarding MURPHY'S SIGN (of cholecystitis/gallbladder) that whether it is sign of ACUTE CHOLECYSTITIS or CHRONIC CHOLECYSTITIS?

3. "the
surgical genius of our generation“
"I think the necropsy will show plaques in
my aorta."

5. EPONYMS
CLINICAL
Murphy’s (kidney) punch (sign)(test) -
1884-USA
(Pasternacki's sign-1888-Europe)
(Goldflam's sign-1900-Poland)
(Latin: succusio renalis)
Percussion/Punch tenderness at the costo-
vertebral angle (CVAT)
In cases of perinephric abscess,
pyelonephritis, renal stone,
hemorrhagic fever with renal
syndrome
Murphy’s syndrome Osteopathia striata-pigmentary dermopathy-white forelock syndrome
Murphy’s sign (test) for metacarpals 3rd MCP joint in line with adjacent MCP
joints in fist
Lunate Dislocation
Murphy’s triad Pain vomiting  Fever Acute appendicitis

6. EPONYMS
INSTRUMENTS
Murphy’s (intestinal
anastomosis) Button
• mechanical device used for suture less
anastomosis of the gallbladder to
the duodenum (his preferred treatment for
acute cholecystitis)
• equally suitable for intestinal anastomoses
credited as the forerunner of the
modern end-to-end stapling
instrument
Murphy drip administration of fluids by proctoclysis in patients with peritonitis
Murphy-Lane bone skid common commercial steel instrument used for femoral head procedures

20. Acute cholecystitis or Chronic Cholecystitis?
REFERNECES IN FAVOUR OF ACUTE CHOLECYSTITIS REFERENCES IN FAVOUR OF CHRONIC CHOLECYSTITIS
Browse’s introduction to the symptoms and signs of surgical disease, 4th
edition, Norman L. Browse, pg. 398
A manual on Clinical surgery 10th edition (S. Das) pg. 470, 510
Schwartz’s Principles of Surgery, 10th edition, pg. 1320 SRB’sClinical Methods in surgery, Sriram Bhat M, Jaypee pg. 479
Bailey & Love’s Short Practice of Surgery, International student’s edition, 26th
edition, Page # 1107
SRB’s Manual of Surgery, 3rd Edition, Sriram Bhat M, Jaypee, pg. 580-1
Essential Surgical Practice , International Student Edition , 5th Edition,Alfred
Cuschieri Page #712
TG13: UpdatedTokyo guidelines for acute cholecystitis
(J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):1-105)
Current Diagnosis andTreatment Surgery, 13th edition, Edited by Gerard M.
Doherty ,Lange, Chapter 25
TheWashington Manual of Surgery, 6th edition, pg. 365
Oxford Handbook of Clinical Surgery, 3rd edition, pg. 300

27. TG13: UpdatedTokyo guidelines for acute cholecystitis
(J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):1-105)

32. Available at surgicalpresenations