The blue scrotum sign of Bryant: a diagnostic clue to ruptured abdominal aortic aneurysm.

A 73-year-old man presented to the emergency department twice with nonspecific abdominal pain. He was diagnosed as having mild diverticulitis and was discharged. Four days later he presented to the emergency department in severe abdominal pain with scrotal and penile ecchymoses. After an initial urologic consultation the correct diagnosis of ruptured abdominal aortic aneurysm was made. We discuss the pathogenesis of the genital discoloration and make the correct historical attribution of this sign to John Henry Bryant, a turn-of-the-century physician at Guy's Hospital.