Possible Causes for Cullen's Sign Acute Pancreatitis Cullen's sign for acute haemorrhagic pancreatitis Department of General Medicine, B.J. [ijmr.org.in] sign : periumbilical ecchymosis and discoloration ( bluish-red ) Grey Turner's sign : flank ecchymosis with discoloration Fox's sign : ecchymosis over the inguinal ligament [amboss.com] Jaundice: indicates obstruction of common bile duct as etiology Hemorrhagic pancreatitis Rare complication Ecchymosis/discoloration around the umbilicus (Cullen’s sign) Ecchymosis [rebelem.com] Pancreatitis What is Cullen and Grey-Turner's Sign? [youtube.com] (Rare) signs of hemorrhage on the physical exam include: Cullen sign : periumbilical bruising Grey-Turner sign : flank bruising There continues to be debate over the precipitating [radiopaedia.org] (Rare) signs of hemorrhage on the physical exam include: Cullen sign: periumbilical bruising Grey-Turner sign: flank bruising There continues to be debate over the precipitating [radiopaedia.org] Retroperitoneal Hematoma Eponymictionary – Cullen sign Journal articles Chan YC, Morales JP, Reidy JF, Taylor PR. [lifeinthefastlane.com] ’s sign (periumbilical ecchymosis) – late finding Grey-Turner’s sign (ecchymosis of the flanks) – late finding *History of risk factors as above Evaluation and Diagnosis 1,3,4,5 [emdocs.net] but may have Cullen sign (umbilical ecchymosis) and Grey Turner sign (flank ecchymosis) +/- palpable swelling haematuria haemodynamic instability and shock evidence of abdominal [lifeinthefastlane.com] Retroperitoneal Hemorrhage but may have Cullen’s sign (umbilical ecchynosis) and Gray-Turner’s sign (flank ecchymosis) +/- palpable swelling haematuria haemodynamic instability and shock evidence [lifeinthefastlane.com] ’s sign (periumbilical ecchymosis) – late finding Grey-Turner’s sign (ecchymosis of the flanks) – late finding *History of risk factors as above Evaluation and Diagnosis 1,3,4,5 [emdocs.net] […] hemangiomas) Secondary trauma iatrogenic (e.g. femoral cannulation, IR cannulation) extension from ruptured AAA ASSESSMENT loin and/ or abdominal pain often no cutaneous signs [lifeinthefastlane.com] Bleeding from an Ectopic Pregnancy Abdominal examination: Cullen’s sign: a periumbilical bluish discoloration may be present due to absorption of the blood in the peritoneal cavity by lymphatics. [gfmer.ch] Abdominal Aortic Aneurysm Subcutaneous ecchymosis of the flank (Grey-Turner sign), periumbilical region (Cullen’s), proximal thigh (Fox’s), or scrotum (Bryant’s) may be present as well — these are [emdocs.net] Ectopic Pregnancy STUDY OBJECTIVE: To demonstrate a technique for the laparoscopic surgical management of cesarean section scar ectopic pregnancy. DESIGN: Step-by-step presentation of the procedure using video (Canadian Task Force classification III). SETTING: Cesarean section scar ectopic pregnancy is a rare form of ectopic[…] [ncbi.nlm.nih.gov] Ruptured Aortic Aneurysm Abstract Acute aortic dissection and a ruptured aortic aneurysm are both catastrophic events that usually present suddenly. Although these conditions are relatively uncommon compared to other diseases treated by the orthopedists as a primary practitioner, they are of primary importance. The purpose of this[…] [ncbi.nlm.nih.gov] Traumatic Rupture of the Kidney Renal Trauma Renal Fracture and Renal Laceration Incidence Up to 10% of injuries coming to emergency room with blunt trauma Causes Motor vehicle accident Contact sports Falls and fights Less often penetrating wounds Mechanism Direct blow (>80%) frequently compressed and often lacerated by lower ribs[…] [learningradiology.com] Leaking Abdominal Aortic Aneurysm We present a case of an 82-year-old lady with recurrent neck swelling and a history of intermittent stridor who subsequently developed a contusion over her lower neck and upper chest. The patient collapsed on her way to have a CT scan and died 24 hours later of a leaking aortic aneurysm. At initial presentation[…] [ncbi.nlm.nih.gov] Traumatic Aortic Rupture Abstract A retrospective review was undertaken to determine the incidence of, and radiologic findings associated with aortic rupture resulting from blunt chest trauma in children. Records and imaging data of 54 consecutive pediatric patients admitted over a 2 year period to a pediatric trauma center after[…] [ncbi.nlm.nih.gov] Pancreatic Phlegmon Grey Turner’s sign, Cullen’s sign and Fox’s sign can be rarely observed in severe acute pancreatitis [19] ( Fig. 17 ). [posterng.netkey.at] Two physical examination signs of acute pancreatitis include Cullen’s sign and Grey Turner’s sign. [dummies.com] Cullen’s sign : Bluish discolouration around the umbilicusGrey Turner’s sign : Greenish brown discolouration of the flanks Fox’s sign : Bruising seen over the inguinal region [slideshare.net] Abdominal Injury • cullen’s sign – 12 hours or later 19. [slideshare.net] Cullen's sign is bruising around the umbilicus. [emsworld.com] […] laparotomy) Inspection abrasions bruising seat belt lap belt: 30% chance of mesenteric or intestinal injury retroperitoneal haemorrhage: ecchymosis of the peri-umbilical area (Cullen [litfl.com] Splenic Hematoma Cullen's sign is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. [en.wikipedia.org] "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. [en.wikipedia.org] 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 [en.wikipedia.org] LPAC Syndrome Type 1 In severe cases, retroperitoneal hemorrhage may produce ecchymoses of the flanks and periumbilical ecchymoses (Cullen sign and Grey-Turner sign). [odlarmed.com] In severe cases, retroperitoneal hemorrhage may produce ecchymoses of the flanks and periumbilical ecchymoses -Cullen sign and Grey-Turner sign. [homeobook.com] sign and Grey Turner sign) in patients with acute hemorrhagic pancreatitis Courvoisier sign: palpable mass in the right upper quadrant in patient with obstructive jaundice [unboundmedicine.com] Abdominal Injury Kidney Injury 14. signs Cullen’s Sign:1918 Bluish discoloration around umbilicus Diffusion of blood along periumbilical tissues or falciform ligament Hemoperitoneum Severe [slideshare.net] Cullen's sign - ie periumbilical ecchymosis - may indicate retroperitoneal haemorrhage. However, this symptom usually takes several hours to develop. [patient.info] […] wounds and abrasions 2-palpate abdomen for localized and diffuse tenderness 3-consider possible internal injuries eg: liver ,spleen and kidney 4-diffuse severe tenderness: a sign [slideshare.net] Hypovolemia Bleeding in the abdominal cavity may lead to classical bruising patterns seen in Cullen’s sign and Turner’s sign. [howshealth.com] Bleeding into the abdominal cavity can cause the classical bruising patterns of Grey Turner's sign (bruising along the sides) or Cullen's sign (around the navel). [14] Stages [en.wikipedia.org] Biliary Colic Sign (periumbilical discoloration) & Turner's Sign (flank discoloration) Labs - Complete Blood Count usually normal - Mild elevation of Liver Function Tests a) Bilirubin [slideshare.net] ’s sign) or in the flanks (Grey Turner’s sign) ERCP and stone removal may be necessary. [fastbleep.com] Cholangitis- Charcot's Triad –Fever, Jaundice, Right Upper Quadrant pain & Reynold's Pentad- Charcot's Triad, Shock and Altered mental status - Pancreatitis- Low grade fever, Cullen's [slideshare.net] Pancreatic Abscess Classic physical examination findings, such as Grey-Turner sign or Cullen sign, are supposedly characteristic of pancreatitis but rarely are noted in clinical practice. [odlarmed.com] sign : periumbilical ecchymosis and discoloration ( bluish-red ) Grey Turner's sign : flank ecchymosis with discoloration Fox's sign : ecchymosis over the inguinal ligament [amboss.com] In the present case, there were abdominal signs and left-sided pleural effusion with basal crepitations, but other signs such as Cullen's sign or Grey-Turner's sign which [ijmm.org] Abdominal Wall Hematoma Voluntary contraction of the rectus muscle by having pt lift head Increases amount of pain experienced with RSH Intra-abdominal mass would be less tender Cullen sign: Periumbilical [fprmed.com] The Cullen sign, periumbilical ecchymosis, in a patient with a rectus sheath hematoma. Rectus sheath hematoma of the right rectus muscle. [reference.medscape.com] […] or Turner's signs) is not always helpful as it often occurs late in the presentation. 2,4 Abdominal ultrasound (US) has only an 80% - 85% diagnostic sensitivity for RSH. [med.ucla.edu] Acquired Spherocytosis sign, Turner's sign). [cancertherapyadvisor.com] […] easily deduced--from the patient's history and physical exam: trauma, surgical sites, extensive hematoma, melana, hematemesis, menorrhagia, epistaxis, third-space hemorrhage (Cullen's [cancertherapyadvisor.com] Basilar Skull Fracture Raccoon eyes Black eye Subungual hematoma Cullen's sign Grey Turner's sign Retroperitoneal hemorrhage Animal bites Insect bite Spider bite Snakebite Other: Ballistic trauma [en.wikipedia.org] Abrasion Avulsion Blisters Blood blister Coma blister Delayed blister Edema blister Fracture blister Friction blister Sucking blister Bruises Hematoma/Ecchymosis Battle's sign [en.wikipedia.org] Cushing Ulcer sign Cullen 徴候 Curling ulcer Curling 潰瘍 Curschmann spiral Curschmann 螺旋 Cushing disease Cushing 病 Cushing syndrome Cushing 症候群 Cushing ulcer Cushing 潰瘍 D-glyceric acidemia [jpeds.or.jp] Crimean-Congo hemorrhagic fever クリミア・コンゴ出血熱 Crohn disease Crohn 病 Crouzon disease Crouzon 病 Cryopin-associated periodic syndrome クリオプリン関連周期性症候群 CAPS Cryptococcus クリプトコックス属/クリプトコックス Cullen [jpeds.or.jp] Adult Krabbe Disease カレン Cullen's sign カレン徴候 Curie キュリー Curie point キュリー点 Curling カーリング Curling's ulcer カーリング潰瘍 Curschmann クルシュマン Curschmann's spiral クルシュマンらせん体 Cushing クッシング Cushing's syndrome [jams.med.or.jp] Cruveilhier-Baumgarten syndrome クリュヴェーリエ・バウムガルテン症候群 LéonJean Baptiste Cruveilhier （1791-1874） French pathologist and Paul Clemens vonBaumgarten （1848-1928） German pathologist Cullen [jams.med.or.jp] Penetrating Abdominal Trauma Cullen's sign is bruising around the umbilicus. [emsworld.com] Cullen's sign - ie periumbilical ecchymosis - may indicate retroperitoneal haemorrhage. However, this symptom usually takes several hours to develop. [patient.info] Two bruising patterns worth noting are Cullen's sign and Grey-Turner's sign, both of which indicate retroperitoneal hemorrhage. [emsworld.com] Lesser Sac Abscess This can lead to periumbilical bruising (Cullen's sign), flank bruising (Grey Turner's sign) and lastly bilateral renal halo sign. [3], [4] Accumulation of pancreatic fluid [jpgmonline.com] Placenta Circumvallata Unilateral radiating to shoulder. shoulder pain (indicative of intraperitoneal bleeding that extends to diaphragm and phrenic nerve) - + Cullen’s Sign – bluish tinged umbilicus [bicolnurses.blogspot.com] Unilateral radiating to shoulder. shoulder pain (indicative of intraperitoneal bleeding that extends to diaphragm and phrenic nerve) + Cullen’s Sign – bluish tinged umbilicus [nursescentermcn.blogspot.com] Auricular Hematoma Raccoon eyes Black eye Subungual hematoma Cullen's sign Grey Turner's sign Retroperitoneal hemorrhage Animal bites Insect bite Spider bite Snakebite Other: Ballistic trauma [en.wikipedia.org] Abrasion Avulsion Blisters Blood blister Coma blister Delayed blister Edema blister Fracture blister Friction blister Sucking blister Bruises Hematoma / Ecchymosis Battle's sign [en.wikipedia.org] Acute Peritonitis Ecchymoses of the costovertebral angles (Grey Turner sign) or around the umbilicus (Cullen sign) suggest hemorrhagic pancreatitis but are not very sensitive for this disorder [msdmanuals.com] Look for signs of bruising around the umbilicus (Cullen's sign - this can be present in haemorrhagic pancreatitis and ectopic pregnancy) or flanks (Grey Turner's sign - this [patient.info] Pancreatic Ascites […] abdominal pain Shock/ARDS Cullen's sign Grey-Turner's Fox's Sign bluish discoloration of the periumbilical area What is Grey-Turner's sign? [quizlet.com] The Grey Turner sign (ecchymoses of the flanks) and the Cullen sign (ecchymoses of the umbilical region) indicate extravasation of hemorrhagic exudate, occur in < 1% of cases [merckmanuals.com] […] bleeding into the parenchyma and retroperitoneal structures with extensive pancreatic necrosis What are the signs of hemorrhagic pancreatitis? [quizlet.com]
