Grey Turner Sign

Excerpt

Grey Turner sign is an uncommon subcutaneous manifestation of intra-abdominal hemorrhage that manifests as ecchymosis or discoloration of the flank. This sign is classically associated with severe acute necrotizing pancreatitis, which can be associated with the Cullen sign (periumbilical ecchymosis) (see Image. Grey Turner and Cullen signs). These conditions carry similarly high mortality rates. In addition, it can also be present in a few other conditions that result in intra-abdominal or retroperitoneal bleeding in someone on anticoagulation, a ruptured abdominal aortic aneurysm, rectus sheath hematoma, and ruptured ectopic pregnancy. The discoloration observed in the flanks can be red, green, yellow, or purple, depending on the degree of red blood cell breakdown in the abdominal wall tissues, similar to bruising seen in any other tissue from traumatic causes. This sign may not be seen initially on clinical exam as it can manifest after several days into the course of an illness. For that reason, the Grey Turner sign is not always considered a sign of acute hemorrhage, but it can suggest a subacute process.