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A Disappearing Grey Turner Sign

Maurice L. Kelley Jr., MD
JAMA. 1963;186(6):596-597. doi:10.1001/jama.1963.63710060042021a.
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IN 1917 Gilbert Grey Turner observed two large discolored areas on the loins of a 53-year-old man with eventually fatal, acute hemorrhagic pancreatitis.1 This dirty-green or bluish, bruised, cutaneous lesion was attributed to the action on the abdominal wall and skin of retroperitoneally extravasated pancreatic juice. During the ensuing years the sign has come to be regarded as an interesting, but late and rather unusual, manifestation of acute pancreatic necrosis and inflammation. More recent observations have shown that nontraumatic ecchymotic discolorations of the flanks and abdominal wall can be seen in association with other forms of serious intra-abdominal pathology, such as small bowel obstruction with strangulation.2 In other cases no obvious cause may be identified, but the appearance of the sign portends a fatal outcome.3-5

It seems important to call attention to the following patient who illustrates an encouraging variant of the usually ominous Grey Turner sign.


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