Citation, DOI, disclosures and article data
Citation:
Carroll D, Jones J, Sharma R, Grey Turner sign. Reference article, Radiopaedia.org (Accessed on 17 Mar 2025) https://radiopaedia.org/articles/83382
The Grey Turner sign refers to the clinical finding of atraumatic flank ecchymosis, which is occasionally associated with retroperitoneal haemorrhage, classically due to haemorrhagic pancreatitis 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.
History and etymology
The sign was first described by George Grey Turner (1877-1951), an English surgeon, in 1919 7.
Several other patterns of non-traumatic cutaneous ecchymosis associated with various aetiologies of retroperitoneal haemorrhage have also been described;
- Fox sign 3
- sharply demarcated ecchymosis located caudal to the inguinal ligament on the anteromedial thigh
- Cullen 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 sign
- ecchymosis extending along the inguinal ligament 6
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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. doi:10.4103/0972-5229.182207 - Pubmed
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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. doi:10.1016/j.ijscr.2012.01.001 - Pubmed
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3. Fox J, Fox. A diagnostic sign of extraperitoneal haemorrhage. (1966) The British journal of surgery. doi:10.1002/bjs.1800530310 - Pubmed
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4. Engamba S, Engamba GD, Engamba BJ, Engamba. Contained ruptured abdominal aortic aneurysm presenting as cauda equina syndrome. (2017) BMJ case reports. doi:10.1136/bcr-2016-216602 - Pubmed
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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. doi:10.1016/j.jemermed.2007.11.066 - Pubmed
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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. doi: - Pubmed
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7. Grey Turner G. Local discoloration of the abdominal wall as a sign of acute pancreatitis. (1919) British Journal of Surgery. 7 (27): 394. doi:10.1002/bjs.1800072711
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