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Cullen Sign and Grey Turner Sign in Acute Pancreatitis

      A 34-year-old man was admitted to our facility with severe epigastric pain and distension of the abdomen for 5 days. He had a history of regular intake of ethanol for the past 10 years (around 100 g/d). On admission, physical examination revealed tachycardia (pulse rate 110 beats per minute), respiratory rate of 26 breaths per minute, and a blood pressure of 100/70 mm Hg. Abdominal examination revealed generalized tenderness and distension along with a reddish discoloration in the periumbilical area (Cullen sign; left panel) and the left flank (Grey Turner sign; right panel) (Figure). On percussion, shifting dullness was found positive. Laboratory investigations revealed significantly elevated serum amylase (554 U/L, reference range 40-140) and lipase (442 U/L, reference range <160). A contrast-enhanced computed tomography scan of the abdomen revealed diffusely heterogeneous pancreas with peri-pancreatic fluid collection. The hemorrhagic collection of fluid was drained under image guidance. The patient gradually recovered following conservative management and was discharged after 2 weeks of hospitalization.
      Figure
      FigureAbdominal examination showing (A) distended abdomen with reddish discoloration in the periumbilical area (Cullen sign) and (B) the left flank (Grey Turner sign).
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