Grey Turner’s sign associated with hemorrhagic pancreatitis

Excerpt

A 59-year-old man with a history of alcohol abuse was admitted to the emergency room with hemodynamic instability and acute abdominal pain radiating into the back. Physical examination revealed abdominal muscle guarding without jaundice. Hemoglobin levels were low (8 g dL⁻¹) and hemodynamic state improved after transfusion of one unit of packed red blood cells and fluid resuscitation (3000 mL of crystalloids). Abdominal computed tomography (CT) confirmed the diagnosis of acute hemorrhagic pancreatitis with an 11 × 14 × 7 cm intra-pancreatic hemorrhagic collection, hemoperitoneum, and splenic infarction (Fig. 1). Associated acute renal failure led to intensive care unit management. Ecchymosis of the right flank appeared at day 1 after admission (Grey Turner’s sign), corresponding to the subcutaneous spread of the hemorrhagic collection around the abdomen (Fig. 2). Unspecific to this condition, this sign is described in approximately 3 % of patients with acute pancreatitis. The patient recovered well despite the poor prognosis usually associated with Grey Turner’s sign.

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