Grey Turner's sign

M, David; Pelberg, Justin; Kuntz, Catherine

doi:10.1093/qjmed/hcs079

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…This, among other factors, requires knowledge of the described skin signs in pancreatitis and other conditions that may cause these specific discolorations. The literature describes certain conditions that potentially cause the Fox sign, such as necrotizing pancreatitis, deep vein thrombosis, and rupture of an abdominal aortic aneurysm [ 8 , 13 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Skin signs associated with pancreatitis are presumably caused by the expansion of intra-and retroperitoneal hemorrhages along anatomic structures, which manifest in the subcutaneous tissue at specific locations, depending on the path of expansion [7]. However, these signs do not solely occur in acute pancreatitis, and many other causes have been identified, including necrotizing pancreatitis, intraperitoneal hemorrhage, portal hypertension, liver cirrhosis anticoagulation with warfarin, or deep vein thrombosis [8][9][10][11][12][13]. Furthermore, they indicate a poor prognosis [14]; therefore, it seems reasonable to raise awareness regarding the potential clinical impact they entail.…”

Section: Introductionmentioning

confidence: 99%

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Fox sign in a case of terminal stage pancreatic cancer and suggestions for diagnosis

Prangenberg

Doberentz

Madea

2021

Forensic Sci Med Pathol

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Skin signs in acute pancreatitis are well-known and frequently discussed manifestations accompanied by unfavorable prognoses although they may rarely appear in clinical and forensic medicine. In 2018, the district attorney’s office ordered a forensic autopsy for a 74-year-old man with terminal stage pancreatic cancer. The autopsy was ordered based on accusations of the deceased’s widow regarding alleged medical malpractice and poor hospital care. The widow filed a grievance about multiple unsuccessful attempts to draw blood from her husband in addition to a diaper dermatitis at the right groin. An autopsy and additional histological examinations were performed. After considering all findings, the diaper dermatitis was eventually assumed to be a Fox sign caused by acute pancreatitis, and the allegations of medical malpractice were refuted. This case led us to identify another case with suspected cutaneous manifestations in pancreatic disease. We performed immunohistochemical staining on those two cases and six control cases to examine whether there was detectable presence of pancreatic lipase and trypsin in the skin discolorations and whether it could be used as a feasible method to verify skin signs associated with pancreatitis. Based on our findings, a minor disseminated lipase and trypsin staining should be considered regular and is therefore not conclusive of a skin sign associated with pancreatitis. Moreover, trypsin does not seem to be as suitable as lipase for this suggested immunohistochemical method. Nevertheless, this method might be a useful addition for determining the origin of skin discoloration and verifying skin signs associated with pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fox sign in a case of terminal stage pancreatic cancer and suggestions for diagnosis

Prangenberg

Doberentz

Madea

2021

Forensic Sci Med Pathol

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“…In the case of ruptured AAA, it is possible to find ecchymosis in the patient (Gray-Turner's sign, Cullen's sign, Fox's sign and Bryant's sign) [51]. Moreover, evidence of distal embolization or ischemia on vascular physical examination supports the diagnosis of AAA [52].…”

Section: Symptomatic Aaamentioning

confidence: 99%

Aortic Aneurysm: Clinical Findings, Diagnostic and Treatment

Kumar¹,

Persaud²,

Leite³

et al. 2021

Aortic Aneurysm - Clinical Findings, Diagnostic, Treatment and Special Situations

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The aorta is the largest artery in the body and can have aneurysms, which are focal expansions of the vessel wall that can occur anywhere throughout the artery. These can be classified as thoracic, abdominal or thoracoabdominal aneurysms and can be caused by several etiologies, including degenerative, infectious, and genetic causes. Most aortic aneurysms are asymptomatic and are detected incidentally while looking for other primary diseases with a physical exam finding of a pulsatile mass, or with imaging such as ultrasound, computed tomography, x-rays, or magnetic resonance imaging. When symptoms are present, they are often nonspecific and occur due to inflammation, rapid expansion, compression/erosion of the aneurysm into surrounding structures, or rupture. Uncontrolled aortic aneurysms can lead to fatal outcomes, thus making proper management essential. Management can range from medical treatment to surgical repair based on location, size, rate of expansion, and presence of symptoms.

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“…They are (1) Grey Turner's sign-ecchymosis of flanks, (2) Cullen's sign-ecchymosis around the umbilicus, (3) Fox's sign-ecchymosis of thigh, and (4) Bryant's sign-bluish discoloration of scrotum. [ 1 ] Causes of Grey Turner's sign and Cullen's sign includes acute pancreatitis, hemorrhagic pancreatitis, retroperitoneal hemorrhage, blunt abdominal trauma, ruptured ectopic pregnancy, spontaneous bleeding following coagulopathy, ruptured aortic aneurysm, ruptured common bile duct, perforated duodenal ulcer, ruptured hepatocellular carcinoma, hepatic lymphoma, Percutaneous liver biopsy, and rectus sheath hematoma. [ 2 3 ]…”

mentioning

confidence: 99%

Another cutaneous sign of acute pancreatitis

Pandiaraja¹

2016

Indian Journal of Critical Care Medicine

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Grey Turner's sign

Cited by 9 publications

References 4 publications

Fox sign in a case of terminal stage pancreatic cancer and suggestions for diagnosis

Fox sign in a case of terminal stage pancreatic cancer and suggestions for diagnosis

Aortic Aneurysm: Clinical Findings, Diagnostic and Treatment

Another cutaneous sign of acute pancreatitis

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