Published in:
01-12-2009 | Original Article
Collins’ sign: validation of a clinical sign in cholelithiasis
Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2009
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Background
Cholelithiasis typically presents with right upper quadrant pain, as can pain from other right upper quadrant organs. Pain of cholelithiasis is often referred to tip of scapula. Professor Paddy Collins drew attention to fact that patients with gallstone pain would attempt to demonstrate this by placing their hand behind the back and thumb pointing upwards. This became known amongst his students as Collins’ sign.
Aim
To evaluate accuracy of Collins’ sign as indicator of cholelithiasis.
Patients and methods
Case–control study performed on 202 patients with symptomatic cholelithiasis and 200 control patients (with oesophagitis, gastritis or duodenal ulcer). Questionnaire examined pain pattern in both groups. The results analysed using t test and χ2 test.
Results
Collins’ sign was positive in 51.5% of gallstone patients and 7.5% of control group (P < 0.001).
Conclusions
Collins’ sign was positive in over half of all patients with cholelithiasis and was useful discriminator in diagnosis of gallstones.