Grey Turner sign

Last revised by Jeremy Jones on 10 Jul 2021

The Grey Turner sign refers to the clinical finding of atraumatic flank ecchymosis, which is occasionally associated with retroperitoneal hemorrhage, classically due to hemorrhagic 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.

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 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 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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