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Cullen's Sign
Cullen's sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. It is named for gynecologist Thomas Stephen Cullen (1869–1953), who first described the sign in ruptured ectopic pregnancy in 1916.T.S. Cullen. Embryology, anatomy, and diseases of the umbilicus together with diseases of the urachus. Philadelphia, Saunders, and London, 1916. This sign takes 24–48 hours to appear and can predict acute pancreatitis, with mortality rising from 8–10% to 40%. It may be accompanied by Grey Turner's sign (bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding. Causes Causes include: * acute pancreatitis, where methemalbumin formed from digested blood tracks around the abdomen from the inflamed pancreas * bleeding from blunt abdominal trauma * bleeding from aortic rupture Aortic rupture is the rupture or breakage of the aorta, the largest artery in the body. Aortic rupture ...
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Edema
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area may feel heavy, and joint stiffness. Other symptoms depend on the underlying cause. Causes may include Chronic venous insufficiency, venous insufficiency, heart failure, kidney problems, hypoalbuminemia, low protein levels, liver problems, deep vein thrombosis, infections, angioedema, certain medications, and lymphedema. It may also occur after prolonged sitting or standing and during menstruation or pregnancy. The condition is more concerning if it starts suddenly, or pain or shortness of breath is present. Treatment depends on the underlying cause. If the underlying mechanism involves Hypernatremia, sodium retention, decreased salt intake and a diuretic may be used. Elevating the legs and support stockings may be useful ...
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Bruise
A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close enough to the epidermis such that the bleeding causes a visible discoloration. The bruise then remains visible until the blood is either absorbed by tissues or cleared by immune system action. Bruises which do not blanch under pressure can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone. Bruises are not to be confused with other similar-looking lesions. (Such lesions include petechia (less than , resulting from numerous and diverse etiologies such as adverse reactions from medications such as warfarin, straining, asphyxiation, platelet disorders and diseases such as '' cytomegalovirus''), purpura (, classified as palpable purpura or non-palpable purpura and indicates various pathologic conditions such as thr ...
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Navel
The navel (clinically known as the umbilicus, commonly known as the belly button or tummy button) is a protruding, flat, or hollowed area on the abdomen at the attachment site of the umbilical cord. All placental mammals have a navel, although it is generally more conspicuous in humans. Structure The umbilicus is used to visually separate the abdomen into quadrants. The umbilicus is a prominent scar on the abdomen, with its position being relatively consistent among humans. The skin around the waist at the level of the umbilicus is supplied by the tenth thoracic spinal nerve (T10 dermatome). The umbilicus itself typically lies at a vertical level corresponding to the junction between the L3 and L4 vertebrae, with a normal variation among people between the L3 and L5 vertebrae. Parts of the adult navel include the "umbilical cord remnant" or "umbilical tip", which is the often protruding scar left by the detachment of the umbilical cord. This is located in the center of the ...
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Gynecologist
Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area of obstetrics and gynecology (OB-GYN). The term comes from Greek and means "the science of women". Its counterpart is andrology, which deals with medical issues specific to the male reproductive system. Etymology The word "gynaecology" comes from the oblique stem (γυναικ-) of the Greek word γυνή (''gyne)'' semantically attached to "woman", and ''-logia'', with the semantic attachment "study". The word gynaecology in Kurdish means "jinekolojî", separated word as "jin-ekolojî", so the Kurdish "jin" called like "gyn" and means in Kurdish "woman". History Antiquity The Kahun Gynaecological Papyrus, dated to about 1800 BC, deals with gynaecological diseases, fertility, pregnancy, contraception, etc. The text is divided into thir ...
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Thomas Stephen Cullen
Thomas Stephen Cullen (November 20, 1868 – March 4, 1953) was a Canadian gynecologist associated with Johns Hopkins Hospital. Born in Bridgewater, Ontario, Cullen was educated at the Toronto Collegiate Institute and the University of Toronto, graduating from the latter school with a Bachelor of Medicine degree in 1890. He began studying at Johns Hopkins University the next year, before traveling to Germany and studying at Johannes Orth's laboratory at the University of Göttingen in 1893. From 1893 to 1896, Cullen was in charge of gynecological pathology at Johns Hopkins, and in 1919 he was named a professor of clinical gynecology. Cullen researched gynecological diseases including uterine cancer and ectopic pregnancy and promoted extensive use of diagrams in biomedical publishing. Cullen's sign, a discoloration of the skin about the navel which is regarded as a sign of a ruptured ectopic pregnancy, is named for him. He wrote alone, and in collaboration, four important monogr ...
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Ectopic Pregnancy
Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. The pain may be described as sharp, dull, or crampy. Pain may also spread to the shoulder if bleeding into the abdomen has occurred. Severe bleeding may result in a fast heart rate, fainting, or shock. With very rare exceptions the fetus is unable to survive. Overall, ectopic pregnancies are very rare, annually affecting less than 2% of pregnancies worldwide. Risk factors for ectopic pregnancy include pelvic inflammatory disease, often due to chlamydia infection; tobacco smoking; prior tubal surgery; a history of infertility; and the use of assisted reproductive technology. Those who have previously had an ectopic pregnancy are at much higher risk of having another one. Most ectopic pregnancies (90%) occur in the fallopian tube, whic ...
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Acute Pancreatitis
Acute pancreatitis (AP) is a sudden inflammation of the pancreas. Causes in order of frequency include: 1) a gallstone impacted in the common bile duct beyond the point where the pancreatic duct joins it; 2) heavy alcohol use; 3) systemic disease; 4) trauma; 5) and, in minors, mumps. Acute pancreatitis may be a single event; it may be recurrent; or it may progress to chronic pancreatitis. Mild cases are usually successfully treated with conservative measures: hospitalization, pain control, nothing by mouth, intravenous nutritional support, and intravenous fluid rehydration. Severe cases often require admission to an intensive care unit to monitor and manage complications of the disease. Complications are associated with a high mortality, even with optimal management. Signs and symptoms Common *severe epigastric pain (upper abdominal pain) radiating to the back in 50% of cases *nausea *vomiting *loss of appetite *fever * chills (shivering) *hemodynamic instability, including ...
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Grey Turner's Sign
Grey Turner's sign refers to bruising of the flanks, the part of the body between the last rib and the top of the hip. The bruising appears as a blue discoloration, and is a sign of retroperitoneal hemorrhage, or bleeding behind the peritoneum, which is a lining of the abdominal cavity. Grey Turner's sign takes 24–48 hours to develop, and can predict a severe attack of acute pancreatitis. Grey Turner's sign may be accompanied by Cullen's sign. Both signs may be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding. Grey Turner's sign is named after British surgeon George Grey Turner. Causes Causes include * Acute pancreatitis, whereby methemalbumin formed from digested blood tracks subcutaneously around the abdomen from the inflamed pancreas. * Pancreatic hemorrhage * Retroperitoneal hemorrhage * Blunt abdominal trauma * Ruptured / hemorrhagic ectopic pregnancy. * Spontaneous bleeding secondary to coagulopathy (congenital or acquired) * Aortic ...
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Retroperitoneal Space
The retroperitoneal space (retroperitoneum) is the anatomical space (sometimes a potential space) behind (''retro'') the peritoneum. It has no specific delineating anatomical structures. Organs are retroperitoneal if they have peritoneum on their anterior side only. Structures that are not suspended by mesentery in the abdominal cavity and that lie between the parietal peritoneum and abdominal wall are classified as retroperitoneal. This is different from organs that are not retroperitoneal, which have peritoneum on their posterior side and are suspended by mesentery in the abdominal cavity. The retroperitoneum can be further subdivided into the following: *Perirenal (or perinephric) space *Anterior pararenal (or paranephric) space *Posterior pararenal (or paranephric) space Retroperitoneal structures Structures that lie behind the peritoneum are termed "retroperitoneal". Organs that were once suspended within the abdominal cavity by mesentery but migrated posterior to the p ...
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Methemalbumin
Methemalbumin (MHA) is an albumin complex consisting of albumin and heme. This complex gives brown color to plasma and occurs in hemolytic and hemorrhagic disorders. Its presence in plasma is used to differentiate between hemorrhagic and edematous pancreatitis. The Schumm test is used to differentiate intravascular haemolysis from extravascular haemolysis, as in haemolytic anaemias Hemolytic anemia or haemolytic anaemia is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular). This most commonly .... A positive result is indicative of intravascular haemolysis. References {{Albumins Proteins ...
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Abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior (anatomy), posterior tagma (biology), tagma of the body; it follows the thorax or cephalothorax. In humans, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint (the intervertebral disc between Lumbar vertebrae, L5 and Vertebra#Sacrum, S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear. In vertebrates, the abdomen is a large body c ...
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Physical Trauma
An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or overexertion. Injuries can occur in any part of the body, and different symptoms are associated with different injuries. Treatment of a major injury is typically carried out by a health professional and varies greatly depending on the nature of the injury. Traffic collisions are the most common cause of accidental injury and injury-related death among humans. Injuries are distinct from chronic conditions, psychological trauma, infections, or medical procedures, though injury can be a contributing factor to any of these. Several major health organizations have established systems for the classification and description of human injuries. Occurrence Injuries may be intentional or unintentional. Intentional injuries may be acts o ...
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