Cullen's sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus.
| Cullen's sign | |
|---|---|
 | |
| Cullen's sign | |
| Specialty | Various |
It is named for gynecologist Thomas Stephen Cullen (1869–1953),[1] who first described the sign in ruptured ectopic pregnancy in 1916.[2]
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[3] (bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding.
Causes
editCauses 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
- bleeding from ruptured ectopic pregnancy
Importance of the sign is on a decline since better diagnostic modalities are now available.
References
edit- ^ synd/1386 at Who Named It?
- ^ T.S. Cullen. Embryology, anatomy, and diseases of the umbilicus together with diseases of the urachus. Philadelphia, Saunders, and London, 1916.
- ^ Bosmann M, Schreiner O, Galle PR (April 2009). "Coexistence of Cullen's and Grey Turner's signs in acute pancreatitis". Am. J. Med. 122 (4): 333–4. doi:10.1016/j.amjmed.2008.08.032. PMID 19332225.