TY - JOUR AU - Bassi, Marco AU - Belmonte, Gelorma AU - Billi, Paola AU - Pasquale, Angelo AU - Reta, Massimo AU - Leandri, Paolo AU - Ferrara, Francesco AU - Ghersi, Stefania AU - D'Imperio, Nicola AU - Nardi, Roberto PY - 2013/04/30 Y2 - 2024/03/28 TI - Skin signs in acute pancreatitis: a case report JF - Italian Journal of Medicine JA - Ital J Med VL - 4 IS - 4 SE - Case Reports DO - 10.4081/itjm.2010.265 UR - https://www.italjmed.org/ijm/article/view/itjm.2010.265 SP - 265-268 AB - Introduction: Subcutaneous manifestations of severe acute pancreatitis (Cullen's sign, Gray- Turner's sign, Fox's sign, and Bryant's sign) are often discussed in journals and textbooks, but seldom observed. Although historically associated with acute pancreatitis, these clinical signs have been described in various other conditions associated with retroperitoneal hemorrhage. <br />Case report: We describe the case of a 61-year-old male with no history of alcohol intake, who was admitted for epigastric pain, vomiting, and increasing serum amylase and lipase levels. Five days after admission, ecchymotic skin discoloration was noted over both flanks (Gray-Turner's sign) and the upper third of the thighs (Fox's sign). Ten days later, he developed multiorgan failure and was transferred to the ICU for 5 days. Computed tomography revealed a large pancreatic fluid collection, which was subjected to EUS-guided drainage. Cholecystectomy was later performed for persistent obstructive jaundice. After more than 4 months of hospitalization, he died as a result of severe gastrointestinal bleeding. <br />Discussion and conclusions: Skin manifestations of retroperitoneal hemorrhage in a patient with acute pancreatitis indicate a stormy disease course and poor prognosis. The severity of acute pancreatitis is currently estimated with validated scoring systems based on clinical, laboratory, and imaging findings. However, skin signs like the ones discussed above can represent a simple and inexpensive parameter for evaluating the severity and prognosis of this disease. ER -