Cullen's sign is superficial

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. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...

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 ar ...

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 ...

(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 sympt ...

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 diseas ...

, 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 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 inj ...

* 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 ruptur ...

* bleeding from ruptured

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

References

External links

{{General injuries Medical signs Ectopic pregnancy