Cullen's sign, also known as umbilical black eye, is superficial

edema Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...

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 clo ...

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

gynecologist Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine concerned with conditions affecting the female reproductive system. It is often paired with the field of obstetrics, which focuses on pre ...

Thomas Stephen Cullen (1869–1953), who first described the sign in ruptured

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 sympto ...

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 include a gallstone impacted in the common bile duct or the pancreatic duct, heavy alcohol use, systemic disease, trauma, elevated calcium levels, hypertriglyceridemia (w ...

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

abdominal The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal ...

trauma * bleeding from

aortic rupture Aortic rupture is the breakage of all walls of the aorta, the largest artery in the body. Aortic rupture is a rare, extremely dangerous condition that is considered a medical emergency. The most common cause is an abdominal aortic aneurysm that ...

* bleeding from ruptured

Importance of the sign is on a decline since better diagnostic modalities are now available.

References

External links

{{General injuries Diagnostic surgery Medical signs Ectopic pregnancy