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An overweight patient with epigastric pain
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Patients often have rapid shallow breathing. This may be due to shock, however diaphragmatic irritation can produce the same finding. Jaundice may indicate that the pancreatitis has been caused by common bile duct stones, or may reflect oedema of the head of the pancreas. Retroperitoneal bleeding can result in flank (Grey-Turner’s sign) or periumbilical bruising (Cullen’s sign).
Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
Acute pancreatitis can be divided into mild and severe or necrotizing pancreatitis. The presenting signs and symptoms of pancreatitis in pregnant patients are similar to those in the nonpregnant population. Characteristic symptoms include acute abdominal pain radiating to the back and associated with nausea and vomiting. Abdominal pain may worsen while lying flat or improve after assuming a forward or fetal position. Obstruction of the common bile duct as it courses through the head of the pancreas can lead to jaundice. Fever, pleuritic pain, and shock may result from peripancreatic fluid collection and pancreatic parenchymal hemorrhage. Physical examination may reveal epigastric tenderness, guarding and rebound, decreased, or absent bowel sounds, ecchymosis of the flank (Grey-Turner’s sign) or periumbilical region (Cullen’s sign) and ascites. Several other diseases such as duodenal ulcer perforation, cholecystitis, hepatitis, bowel obstruction, diabetic ketoacidosis, and pre-eclampsia may share a similar presentation (122).
Practice paper
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Grey Turner’s sign is bruising along the flanks and is seen in haemorrhagic pancreatitis. It represents retroperitoneal and intraabdominal bleeding where altered blood tracks subcutaneously. Similar bruising around the umbilicus is known as Cullen’s sign. (2)
Clinical spectrum, risk factors, management and outcome of patients with retroperitoneal hematoma: a retrospective analysis of 3-year experience
Published in Expert Review of Hematology, 2020
Kamal Kant Sahu, Ajay Kumar Mishra, Amos Lal, Susan V. George, Ahmad Daniyal Siddiqui
Clinical signs especially dermatological findings are easy to recognize and often extremely helpful in detecting concealed pathologies [20–31]. In our series, four patients also complained of abdominal wall discoloration as a presenting feature. It is worth mentioning classical dermatological signs not limited to but seen in RPH: Grey Turner’s sign (ecchymosis/discoloration of the flanks), Cullen’s sign (periumbilical ecchymosis), Fox’s sign (upper thigh along the inguinal ligament), Bryant’s sign (blue discoloration of the scrotum), Stabler’s sign (bruising of the pubis and groin). Also, the presence of Carnett’s sign (worsening of abdominal pain on straight leg raising or lifting the shoulders) or Fothergill sign (persistence of abdominal wall swelling on a straight leg raising) indicate the presence of concomitant rectus sheath hematoma.
Pregnancy and subsequent uterine rupture in a 72-year-old gravida: medical tourism versus procreative freedom
Published in Journal of Obstetrics and Gynaecology, 2018
Physical re-examination of the patient demonstrated significant umbilical bruising (Cullen’s sign, Harris and Naina 2008) and flank ecchymosis (Grey Turner’s sign, Figure 1(B)). She was resuscitated with crystalloid and packed red blood cells (pRBCs), while awaiting an exploratory laparotomy. In the operating theatre she was given additional pRBCs, fresh frozen plasma, platelets, and cryoprecipitate as she developed disseminated intravascular coagulation (DIC). Following the vertical skin incision, approximately three litres of haemoperitoneum was noted upon entrance of the abdomen that was evacuated, while the uterus was identified. The gravid, previously unscarred, uterus was spontaneously ruptured at the fundus (Figure 1(C)). The intact amniotic sac, the placenta and the foetus were delivered. The neonatal intensive care unit (ICU) team confirmed foetal demise at delivery.