American Association of Critical-Care Nurses (AACN) Certification Practice Test

What condition is characterized by atraumatic ecchymosis in the flank?

1. Acute pancreatitis

2. Cholecystitis

3. Ruptured spleen

4. Intestinal obstruction

The correct answer is: Acute pancreatitis

The condition characterized by atraumatic ecchymosis in the flank is primarily associated with acute pancreatitis. This phenomenon is known as Grey Turner's sign, where the bruising appears around the flank area due to bleeding from the pancreas or surrounding vessels, often as a result of inflammatory processes or hemorrhage due to necrotizing pancreatitis. In acute pancreatitis, enzymes that are typically confined to the pancreas begin to leak into surrounding tissues, leading to inflammation and, in some cases, hemorrhage. As blood seeps into the tissues, it can cause discoloration that is visible on the skin surface, presenting as ecchymosis. The presence of such a sign indicates a severity of the condition and potential complications that may require more intensive medical intervention. Other options, such as cholecystitis, ruptured spleen, or intestinal obstruction, do not typically present with flank ecchymosis in the same manner as acute pancreatitis. While these conditions may have associated bruising or abdominal pain, they do not focus on the flank in a way that directly ties to the characteristic bruising described in the context of acute pancreatitis.