Grey Turner's sign explained

Grey Turner's sign
Differential:	Acute pancreatitis, ectopic pregnancy

Grey Turner's sign refers to bruising of the flanks, the part of the body between the last rib and the top of the hip. The bruising appears as a blue discoloration, and is a sign of retroperitoneal hemorrhage, or bleeding behind the peritoneum, which is a lining of the abdominal cavity. Grey Turner's sign takes 24–48 hours to develop, and can predict a severe attack of acute pancreatitis.^[1]

Grey Turner's sign may be accompanied by Cullen's sign. Both signs may be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding. Grey Turner's sign is named after British surgeon George Grey Turner.

Causes

Causes include

• Acute pancreatitis, whereby methemalbumin formed from digested blood tracks subcutaneously around the abdomen from the inflamed pancreas.
• Pancreatic hemorrhage
• Retroperitoneal hemorrhage
• Blunt abdominal trauma
• Ruptured / hemorrhagic ectopic pregnancy.
• Spontaneous bleeding secondary to coagulopathy (congenital or acquired)
• Aortic rupture, from ruptured abdominal aortic aneurysm or other causes.^[2]

History

It is named after British surgeon George Grey Turner.^[3]

Notes and References

1. Bosmann M, Schreiner O, Galle PR . Coexistence of Cullen's and Grey Turner's signs in acute pancreatitis . Am. J. Med. . 122 . 4 . 333–4 . April 2009 . 19332225 . 10.1016/j.amjmed.2008.08.032 .
2. Book: Goldman, Lee. Goldman's Cecil Medicine. 2012. Elsevier Saunders. Philadelphia. 978-1437727883. 837. 24th.
3. Turner. G. Grey. Local discoloration of the abdominal wall as a sign of acute pancreatitis. British Journal of Surgery. 1919. 7. 27. 394–395. 10.1002/bjs.1800072711. 72710780.