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Cullen's Sign

March 3rd, 2023


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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