Friday, 10 January 2014

Cullens Sign

Cullen's Sign
DESCRIPTION
Peri-umbilical ecchymoses.
ASSOCIATED with :
=>More common
♣Retroperitoneal bleeding
♣Post surgery
♣Iatrogenic - anticoagulation complication, postoperative
♣Rectus sheath haematoma
=>Less common
♣Ectopic pregnancy
♣Intrahepatic haemorrhage
♣Ischaemic bowel
♣Ruptured abdominal aortic aneurysm
♣Amoebic liver cyst
♣Perforated duodenal ulcer
MECHANISM/S
The final common pathway in most mechanisms is retroperitoneal bleeding. The retroperitoneum is connected to the gastro-hepatic ligament and then to the falciform ligament and finally to the round ligament (the obliterated umbilical vein), which tracks to the abdominal wall around the umbilicus. When a haemorrhage (from any cause) occurs, blood is able to move along these ligaments to the abdominal wall to produce ecchymoses.


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