Cullen’s Sign in Acute Hemorrhagic Pancreatitis

 ADVANCED RESEARCH IN GASTROENTEROLOGY &HEPATOLOGY JUNIPER PUBLISHERS

Authored by Ali Aamar

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A 66-year-old male with a history of alcohol abuse presented with epigastric pain for two days. He had been drinking heavily for one year. The serum lipase level was markedly elevated (10,219 IntUnit/L; Normal range 23 to 300 IntUnit/L). The physical examination showed periumbilical ecchymosis (Cullen’s sign, Figure A). The CT abdomen suggested diffuse pattern of edema in pancreas with small areas of increased attenuation, consistent with acute hemorrhagic pancreatitis. Patient had a prolonged hospital stay complicated by bilateral exudative pleural effusions secondary to acute pancreatitis. Cullen’s sign (ecchymosis of the periumbilical region) and Grey Turner’s sign (ecchymosis of the flank) suggests retroperitoneal hemorrhage associated with severe pancreatic necrosis and high mortality. Early recognition of these physical examination findings can help appropriately triage high risk patients (Figure 1).


Keywords: Hemorrhagic pancreatitis; Cullen’s sign


 


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