Non-traumatic abdominal ecchymosis of the abdominal wall and flanks (Grey Turner, Cullen and Stabler); scrotum (Bryant) and upper thigh (Fox) as clues to potentially serious causes of abdominal pathology.
Grey Turner sign refers to bruising of the flanks. Originally described 1919 (published 1920) by George Grey Turner (1877–1951) most commonly associated with acute pancreatitis
Fox's sign: non-traumatic ecchymosis over the upper outer aspect of the thigh secondary to abdominal haemorrhage. First described by English surgeon John Adrian Fox in 1966
A 57 year old man presents to the ED with 18 hours of severe upper abdominal pain, fever, nausea and vomiting. He looks jaundiced, his HR is 120bpm, BP 110/60, RR 22 and his temperature is 37.8oC. He is tender and guarded in his right upper quadrant on abdominal palpation.
Pancreatitis is inflammation of the pancreas and involves activation of proteolytic enzymes that may progress to haemorrhagic necrosis of the pancreatic parenchyma