Cullen’s Sign | Signs - MedSchool
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Cullen’s Sign

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Cullen's Sign

  • The presence of Cullen's sign and Grey-Turner's sign are suggestive of retroperitoneal haemorrhage.
  • Cullen's sign occurs due to tracking of blood along the gastrohepatic and falciform ligaments into the umbilical area.
    • Look For

    • Bluish discolouration / bruising around the umbilicus.
    • Causes of Cullen's Sign

    • Pancreatic - acute pancreatitis, trauma
    • Gynaecologic - ruptured ectopic pregnancy, ovarian enlargement
    • Gastrointestinal - perforated duodenal ulcer
    • Hepatobiliary - hepatocellular carcinoma, lymphoma, amoebic abscess
    • Splenic - rupture
    • Vascular - ruptured AAA / internal iliac aneurysm
    • Iatrogenic
  • Cullen's sign was first identified by Cullen in 1918 in a patient with ruptured ectopic pregnancy. Over time it has been associated with acute haemorrhagic pancreatitis and then many other conditions, though the common thread is the presence of retroperitoneal haemorrhage.
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