Cullen's sign is superficial edema and

bruising 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 clos ...

in the subcutaneous fatty tissue around the umbilicus. It is named for

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 ...

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 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 disea ...

, with mortality rising from 8–10% to 40%. It may be accompanied by

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, ...

(bruising of the flank), which may then be indicative of pancreatic necrosis with

retroperitoneal 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 thei ...

or intra-abdominal bleeding.

Causes

Causes include: * acute pancreatitis, where

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 edemato ...

formed from digested blood tracks around the abdomen from the inflamed pancreas * bleeding from blunt

abdominal 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 ...

trauma Trauma most often refers to: * Major trauma, in physical medicine, severe physical injury caused by an external source * Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic i ...

* bleeding from

aortic rupture Aortic rupture is the rupture or breakage of the aorta, the largest artery in the body. Aortic rupture is a rare, extremely dangerous condition. The most common cause is an abdominal aortic aneurysm that has ruptured spontaneously. Aortic rupture ...

* bleeding from ruptured ectopic pregnancy Importance of the sign is on a decline since better diagnostic modalities are now available.

References

External links

{{General injuries Medical signs Ectopic pregnancy