Cullen Sign is characterized by bruising around the

• A. Periumbilical bruising
• B. Flank bruising
• C. Left shoulder pain
• D. Bruising around the eyes

Answer: (A)

Cullen's sign is periumbilical bruising, reflecting intra-abdominal bleeding that tracks to the subcutaneous tissues around the umbilicus. The blood spreads along tissue planes from the intraperitoneal or retroperitoneal space to the area around the navel, producing a bruise there. This sign can accompany serious conditions like acute pancreatitis, ruptured ectopic pregnancy, or abdominal trauma, and it may appear hours to days after the bleeding starts.

This is different from flank bruising (Grey Turner's sign), which points to retroperitoneal hemorrhage; left shoulder pain (Kehr's sign), indicating diaphragmatic irritation from intra-abdominal blood; and bruising around the eyes, which is unrelated to Cullen's sign. So bruising around the umbilicus best identifies Cullen's sign.