Grey Turner sign

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The Grey-Turner's sign refers to the clinical finding of atraumatic flank ecchymosis, which is occasionally associated with retroperitoneal hemorrhage ². It is thought to occur when blood extravasates from the posterior pararenal space and crosses through the transversalis fascia, emerging subcutaneously after dissecting along the lateral aspect of the quadratus lumborum.

Differential diagnosis

Several other patterns of non-traumatic cutaneous ecchymosis associated with various etiologies of retroperitoneal hemorrhage have also been described;

Fox Sign ³
- sharply demarcated ecchymosis located caudal to the inguinal ligament on the anteromedial thigh
Cullen’s Sign
- periumbilical ecchymosis thought to represent egress of retroperitoneal blood along the falciform ligament
scrotal sign of Bryant
- painless, diffuse scrotal and penile ecchymosis/blue discoloration
- classically associated with a ruptured abdominal aortic aneurysm ⁵
Stabler’s sign
- ecchymosis extending along the inguinal ligament ⁶

-The Grey-Turner's sign refers to the clinical finding of atraumatic flank ecchymosis, which is occasionally associated with <a title="Retroperitoneal hemorrhage" href="/articles/retroperitoneal-haemorrhage">retroperitoneal hemorrhage</a> 2. It is thought to occur when blood extravasates from the <a title="Posterior pararenal space" href="/articles/posterior-pararenal-space">posterior pararenal space</a> and crosses through the transversalis fascia, emerging subcutaneously after dissecting along the lateral aspect of the <a title="Quadratus lumborum muscle" href="/articles/quadratus-lumborum-muscle-1">quadratus lumborum</a>. <h4>Differential diagnosis</h4>Several other patterns of non-traumatic cutaneous ecchymosis associated with various etiologies of retroperitoneal hemorrhage have also been described;<ul>
+The Grey-Turner's sign refers to the clinical finding of atraumatic flank ecchymosis, which is occasionally associated with <a href="/articles/retroperitoneal-haemorrhage">retroperitoneal hemorrhage</a> 2. It is thought to occur when blood extravasates from the <a href="/articles/posterior-pararenal-space">posterior pararenal space</a> and crosses through the transversalis fascia, emerging subcutaneously after dissecting along the lateral aspect of the <a href="/articles/quadratus-lumborum-muscle-1">quadratus lumborum</a>.<h4>Differential diagnosis</h4>Several other patterns of non-traumatic cutaneous ecchymosis associated with various etiologies of retroperitoneal hemorrhage have also been described;<ul>
-<li>Cullen’s Sign<ul><li>periumbilical ecchymosis thought to represent egress of retroperitoneal blood along the <a title="Falciform ligament" href="/articles/falciform-ligament">falciform ligament</a>
+<li>Cullen’s Sign<ul><li>periumbilical ecchymosis thought to represent egress of retroperitoneal blood along the <a href="/articles/falciform-ligament">falciform ligament</a>
~~-<li>classically associated with a ruptured <a title="Abdominal aortic aneurysm" href="/articles/abdominal-aortic-aneurysm">abdominal aortic aneurysm</a> 5~~
+<li>classically associated with a ruptured <a href="/articles/abdominal-aortic-aneurysm">abdominal aortic aneurysm</a> 5

References changed:

1. Pandiaraja J. Another cutaneous sign of acute pancreatitis. (2016) Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine. 20 (5): 313-4. <a href="https://doi.org/10.4103/0972-5229.182207">doi:10.4103/0972-5229.182207</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27275087">Pubmed</a>
2. Rahbour G, Ullah MR, Yassin N, Thomas GP. Cullen's sign - Case report with a review of the literature. (2012) International journal of surgery case reports. 3 (5): 143-6. <a href="https://doi.org/10.1016/j.ijscr.2012.01.001">doi:10.1016/j.ijscr.2012.01.001</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22365919">Pubmed</a>
3. Fox J, Fox. A diagnostic sign of extraperitoneal haemorrhage. (1966) The British journal of surgery. <a href="https://doi.org/10.1002/bjs.1800530310">doi:10.1002/bjs.1800530310</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/5907449">Pubmed</a>
4. Engamba S, Engamba GD, Engamba BJ, Engamba. Contained ruptured abdominal aortic aneurysm presenting as cauda equina syndrome. (2017) BMJ case reports. <a href="https://doi.org/10.1136/bcr-2016-216602">doi:10.1136/bcr-2016-216602</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28062419">Pubmed</a>
5. Dargin J, Dargin LR, Dargin. Ruptured abdominal aortic aneurysm presenting as painless testicular ecchymosis: the scrotal sign of Bryant revisited. (2011) The Journal of emergency medicine. <a href="https://doi.org/10.1016/j.jemermed.2007.11.066">doi:10.1016/j.jemermed.2007.11.066</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18614326">Pubmed</a>
6. Epperla N, Epperla MJ, Epperla YS, Epperla. A Review of Clinical Signs Related to Ecchymosis. (2015) WMJ : official publication of the State Medical Society of Wisconsin. <a href="https://doi.org/">doi:</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26756058">Pubmed</a>

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