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Cullen Sign

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Cullen Sign
(A) Periumbilical ecchymosis (Cullen sign) and (B) flank ecchymosis (Grey Turner sign)[1]
  • Cullen’s sign
  • Periumbilical ecchymosis
  • Umbilical ecchymosis
  • Periumbilical bruising
  • Umbilical bruising

Purpose

  • Identify possible intra-abdominal or retroperitoneal hemorrhage
  • Serve as a late clinical clue in critically ill patients
  • Raise suspicion for serious underlying pathology requiring urgent evaluation

Description

  • Bluish-purple discoloration around the umbilicus
  • Represents subcutaneous tracking of blood along fascial planes
  • Typically appears 24–72 hours after onset of bleeding
  • Often associated with other ecchymotic signs (e.g., flank bruising)

Pathology

  • Caused by intraperitoneal or retroperitoneal bleeding
  • Most commonly associated with:
    • Acute pancreatitis (hemorrhagic)
    • Ruptured ectopic pregnancy
    • Abdominal trauma
    • Ruptured abdominal aortic aneurysm

Evidence

  • Unknown

See Also

References

  1. ↑ Wright, William F. "Cullen sign and grey turner sign revisited." Journal of Osteopathic Medicine 116.6 (2016): 398-401.
Created by:
John Kiel on 25 April 2026 18:26:01
Authors:
Last edited:
8 June 2026 10:33:20
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