Francis Edward Stabler

Francis (Frank) Edward Stabler (1902-1967) was an English surgeon, obstetrician and gynaecologist.

Educated in Darlington and Durham, Stabler was described as an ‘assiduous student, good at all things which interested him‘…spending his spare time outdoors, shooting, fishing and exploring the coastline and moors of Northumberland.

He became a dexterous surgeon and able diagnostician. He was a popular teacher of both medical and nursing students. In 1935 he was one of the original small team of obstetricians who introduced and operated the Newcastle Emergency Obstetric Service – the “Flying Squad“. He was an active member and one time President of the North of England Obstetrical and Gynaecological Society.

Eponymously affiliated with Stabler sign (1934), non-traumatic abdominal wall ecchymosis in the inguinal-pubic area associated with ectopic pregnancy.

Biography

• Born September 23, 1902 in Darlington, England
• 1925 – MBBS, University of Durham (MD 1928)
• 1926-1928 Resident training at the Royal Victoria Infirmary, Newcastle
• 1928 – MD, University of Durham. Thesis on the lead treatment of cancer; Honorary gynaecological and obstetrical registrar at the Royal Victoria Infirmary and the Princess Mary Maternity Hospital
• 1929 – Fellow of the Royal College of Surgeons (FRCS)
• 1935 – Developed and operated, with a small team of fellow obstetricians, the Newcastle Emergency Obstetric Service
• 1939 – Honorary assistant gynaecologist to the Royal Victoria Infirmary and Princess Mary Maternity Hospital
• WW II – Surgeon-Commander at the Chatham Naval Hospital (1939-1942); surgical specialist at the RN Auxiliary Hospital, Sherbome, Dorset (1942-1945); in charge of the surgical division of the RN Auxiliary Hospital at Trincomalee in Ceylon (1945-1946) – earning the Volunteer Reserve Decoration (VRD)
• 1945 – Fellow of the Royal College of Obstetricians and Gynaecologists (FRCOG)
• 1953 – Consultant in obstetrics and gynaecology to the South East Northumberland Group of Hospitals
• Died October 13, 1967

Medical Eponyms

Stabler sign (1934)

Non-traumatic abdominal skin ecchymosis in the inguinal-pubic area associated with intra-abdominal haemorrhage, originally described in ectopic pregnancy

In 1934 Stabler published a paper titled ‘A case showing Cullen’s sign‘ concerning a patient presenting with an ectopic pregnancy: with left illiac fossa pain of fourteen days duration and ilioinguinal ‘bruising’, 7 weeks post last menstrual period.

Clinical examination

C.S. Aged 34: One inch below and to the left of the umbilicus was a purple, almost black, clearly cut mark 3/4 in. by 1/4 in. shaped like a comma. Below it, about the junction of the upper third and lower two-thirds of the distance from the umbilicus to the pubes, was a ” bruise,” bluish in colour, about 1 in. in diameter, whilst abutting on the inguinal fold was a reddish-purple mark like a fresh bruise, shaped roughly like the ace of clubs, about 2 in. in diameter. The whole was within the triangle formed by the midline and a line drawn to the umbilicus from the middle of the left inguinal ligament. On bimanual examination a soft mass the size of a hen’s egg was evident in the left tubal region.

Operative findings

At operation the distal half of the left Fallopian tube contained an ampullary pregnancy surrounded by blood clot. The tube was not ruptured, but a little dark blood was oozing from the abdominal ostium…incision into the subcutaneous fatty tissue proved the stains to be true ecchymoses.

Clinical context

Initially described as an inguinal-pubic extension of the peri-umbilical ecchymosis of Cullen sign. Further cases of bruising to the inguinal-pubic area reported with AAA rupture and acute hemorrhagic pancreatitis

Although rare, this sign has most commonly been identified in neonates secondary to adrenal hemorrhage. This is associated with obstetric injury, perinatal hypoxia, and sepsis [Urology 2002]. Rarely, it may be due to ruptured neuroblastoma.

Major Publications

• Stabler F. A case showing Cullen’s sign. Br Med J. 1934;2(3840):255-256.
• Stabler F. Ante-partum Haemorrhage. Br Med J. 1955; 1(4922): 1145–1147
• Stabler F. The Obstetric Emergency Service. Br Med J. 1964; 2(5401): 103–106
• Stabler F, Szekely P. Cardiac disease in pregnancy. J Obstet Gynaecol Br Emp. 1952; 59(4): 567-569
• Stabler F. Extra-uterine Live Child. Br Med J. 1938; 1(4031): 779-798

References

Biography

• Obituary: F.E. Stabler. Br Med J 1967; 4: 240
• Obituary: F.E. Stabler. Lancet 1967; 290(7521): 898
• Obituary: Frank Stabler. Shooting Times and Country Magazine 28 October 1967
• Biography: Stabler, Francis Edward (1902 – 1967). Plarr’s Lives of the Fellows Online. Royal College of Surgeons of England.
• Bibliography. Stabler, Francis Edward. WorldCat Identities

Eponymous terms

• Cadogan M. Atraumatic abdominal ecchymosis. 2020

Mike Cadogan

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |