(BMJ)—A 37-yo plumber w/ hx of heavy alcohol use presented w/ abdominal pain w/ nausea, vomiting, and constipation of 4 days’ duration. Exam: HR 120, BP 110/80, respiratory rate 24. Abdomen: distended; ecchymosis on L flank, R inguinoscrotal area, bilateral calves. Labs: platelets 1.73×109/L; INR 1.4; lipase 391 U/L. CT confirmed the dx. What is it?
Acute pancreatitis
Ruptured abdominal aortic aneurysm
Disseminated intravascular coagulation
Perforated duodenal ulcer
Multisystem trauma
You are correct. CT of abdomen revealed edematous pancreas w/ peripancreatic fluid collection consistent w/ acute pancreatitis. This pt exhibited 3 ecchymotic eponyms involving the abdomen and groin: Grey Turner sign (lateral abdominal wall), Stabler sign (inguinal pubic region), and Fox sign (lateral thigh). These signs are usually indicative of a surgical or OB emergency such as a perforated duodenal ulcer or ruptured ectopic pregnancy. The pt was treated w/ tramadol, pantoprazole, vitamin B12, thiamine, and IV fluids. He was able to tolerate oral fluids on day 3. By the 7th day, his ecchymotic patches began gradually fading, and he was discharged on the 9th day.

BMJ Case Reports CP 2020;13:e235147.
By vgreene, 1 June, 2020
By vgreene, 1 June, 2020
By vgreene, 1 June, 2020
By vgreene, 1 June, 2020
By vgreene, 1 June, 2020