Cullen's Sign
March 3rd, 2023
Overview
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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