Grey Turner’s Sign is a clinical finding characterized by ecchymosis (bruising) or discoloration of the flanks, and it serves as an important physical sign of intra-abdominal hemorrhage, most notably associated with acute pancreatitis.
- Clinical significance:
- Represents retroperitoneal bleeding that dissects along fascial planes to the subcutaneous tissue of the flanks.
- Typically appears 24–48 hours after symptom onset.
- Found in 1%–3% of cases of acute pancreatitis, but may also be seen in:
- Abdominal trauma
- Ruptured ectopic pregnancy
- Spontaneous retroperitoneal hemorrhage
- Perirenal hematomas
- The pathophysiology involves blood tracking from the retroperitoneum through fascial planes to the subcutaneous tissues of the flanks. In acute pancreatitis, pancreatic enzymes and blood extravasate, traveling along anatomical planes to the flank area, where they become visible as bruising.
- Grey Turner’s sign is often discussed together with Cullen’s sign, which refers to periumbilical ecchymosis, as both are signs of severe intra- or retroperitoneal bleeding.
- Eponym Origins: Dr. George Grey Turner (1877–1951):
- British surgeon who described the sign in 1919 in The British Journal of Surgery.
- Observed “two large discolored areas in the loins… dirty-greenish colour,” in a patient later confirmed to have acute pancreatitis.
- He was trained in Newcastle upon Tyne and served in World War I with the Royal Army Medical Corps.
- Later became Professor of Surgery at the University of Durham and President of the Medical Society of London.
Historical Note: In the same 1919 paper, Grey Turner also described what we now call Cullen’s sign (periumbilical ecchymosis) in a separate case—though he didn’t refer to it by name.
For original article, click here.
A comparison between Cullen’s sign and Grey Turner’s sign:
