Cullen's sign
| Cullen's sign |
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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),[1] an obstetrician 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 intraabdominal bleeding.
Causes
Causes include:
- acute pancreatitis, where methemalbumin formed from digested blood tracks around the abdomen from the inflamed pancreas
- bleeding from blunt abdominal trauma
- bleeding from ruptured abdominal aortic aneurysm
- bleeding from ruptured ectopic pregnancy
Importance of the sign is on a decline since better diagnostic modalities are now available.
References
- ^ 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 (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.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link)
Parikh RP, Upadhyay KJ. Cullen's sign for acute haemorrhagic pancreatitis. Indian J Med Res [serial online] 2013 [cited 2013 Jul 4];137:1210 http://www.ijmr.org.in/text.asp?2013/137/6/1210/114397
External links
- . GPnotebook https://www.gpnotebook.co.uk/simplepage.cfm?ID=745209861.
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