Collins' sign: validation of a clinical sign in cholelithiasis.
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.


OBJECTIVE
To evaluate accuracy of Collins' sign as indicator of cholelithiasis.


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 χ(2) 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.
Gilani
S N S
SN
Bon Secours Hospital, Glasnevin, Dublin, Ireland. drnadiagilani7@hotmail.com
Bass
G
G
Leader
F
F
Walsh
T N
TN
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D016022:Case-Control Studies; D002769:Cholelithiasis / Q000175:diagnosis*; D005260:Female; D042882:Gallstones / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053591:Referred Pain / Q000209:etiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012540:Scapula
Scand J Gastroenterol. 2006 Jan;41(1):93-101
16373282
Rev Prat. 2007 Dec 15;57(19):2123-8
18303789
Ann Emerg Med. 1996 Sep;28(3):267-72
8780468
BMJ. 2001 Nov 17;323(7322):1170-3
11711412
Am J Med. 1990 Jul;89(1):29-33
2368790
Postgrad Med. 1991 Oct;90(5):119-26
1924000