Final answer:
Kehr's sign indicates a ruptured spleen and is characterized by pain in the left shoulder, chest, and neck. Bowel sounds in the chest are often due to a diaphragmatic hernia or injury. Referred pain explains why Kehr's sign is felt in areas other than where the spleen is located.
Step-by-step explanation:
When you hear bowel sounds in the chest and see Kehr's sign, these are typically indications of a ruptured spleen. Kehr's sign is characterized by pain in the left shoulder, chest, and neck regions after such a rupture. The unexpected presence of bowel sounds in the chest can occur with certain conditions like diaphragmatic hernia or injury, where abdominal contents, including parts of the digestive system, are abnormally displaced into the chest cavity. The reason Kehr's sign is experienced in regions other than the spleen is due to referred pain. The spleen sits just inferior to the diaphragm in the upper-left abdominopelvic cavity, and when the spleen ruptures, blood spills into this region, putting pressure on the diaphragm. This can trigger referred pain in areas that share the same spinal nerve innervation as the diaphragm, largely in the cervical region.