Cullen's sign
Encyclopedia
Cullen's sign is superficial edema
and bruising
in the subcutaneous fatty tissue around the umbilicus
.
It is named for Thomas S. Cullen (1869-1953), an obstetrician who first described the sign in ruptured ectopic pregnancy
in 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 intraabdominal bleeding.
Importance of the sign is on a decline since better diagnostic modalities are now available
Edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...
and bruising
Bruise
A bruise, also called a contusion, is a type of relatively minor hematoma of tissue in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep into the surrounding interstitial tissues. Bruises can involve capillaries at the level of skin, subcutaneous tissue, muscle,...
in the subcutaneous fatty tissue around the umbilicus
Navel
The navel is a scar on the abdomen caused when the umbilical cord is removed from a newborn baby...
.
It is named for Thomas S. Cullen (1869-1953), an obstetrician who first described the sign in ruptured ectopic pregnancy
Ectopic pregnancy
An ectopic pregnancy, or eccysis , is a complication of pregnancy in which the embryo implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the parent, since internal haemorrhage is a life threatening complication...
in 1916.
This sign takes 24-48 hours to appear and can predict acute pancreatitis
Acute pancreatitis
Acute pancreatitis or acute pancreatic necrosis is a sudden inflammation of the pancreas. It can have severe complications and high mortality despite treatment...
, with mortality rising from 8-10% to 40%. It may be accompanied by Grey Turner's sign (bruising of the flank
Flank
Flank may refer to:* Flank, the side of either a horse or a military unit*Flanking maneuver in military tactics* Flank , the waveform edge formed when a signal goes high or low...
), which may then be indicative of pancreatic necrosis with retroperitoneal or intraabdominal bleeding.
Causes
Causes include:- acute pancreatitis, where methemalbuminMethemalbuminMethemalbumin 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....
formed from digested blood tracks around the abdomen from the inflamed pancreas - bleeding from blunt abdominalAbdomenIn vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...
traumaPhysical traumaTrauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death... - bleeding from ruptured abdominal aortic aneurysmAbdominal aortic aneurysmAbdominal aortic aneurysm is a localized dilatation of the abdominal aorta exceeding the normal diameter by more than 50 percent, and is the most common form of aortic aneurysm...
- bleeding from ruptured ectopic pregnancy
Importance of the sign is on a decline since better diagnostic modalities are now available
