Cullen's and Turner's Signs
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《新英格兰医药杂志》
A 72-year-old man with unstable angina was admitted to the hospital. On the sixth day of heparin therapy, the hemoglobin level decreased from 11.7 to 9.4 g per deciliter. On physical examination, the vital signs were stable, and there was a grade 3/6 systolic murmur consistent with aortic stenosis. Ecchymoses in the periumbilical region (Cullen's sign) (Panel A) and flank (Turner's sign) (Panel B) were noted. Computed tomographic scanning confirmed a retroperitoneal hemorrhage. In 1918, Cullen was the first to describe an umbilical discoloration in a patient with a ruptured extrauterine pregnancy. In 1919, Turner described a "dirty green" discoloration of the loin associated with acute pancreatitis.
In acute pancreatitis, Cullen's or Turner's sign occurs in approximately 3 percent of patients and is associated with a mortality of 37 percent. Although most commonly described in hemorrhagic pancreatitis, neither of these signs is specific to this condition.
Farouk Mookadam, M.D.
Maja Cikes, M.D.
Mayo Clinic
Rochester, MN 55905
In acute pancreatitis, Cullen's or Turner's sign occurs in approximately 3 percent of patients and is associated with a mortality of 37 percent. Although most commonly described in hemorrhagic pancreatitis, neither of these signs is specific to this condition.
Farouk Mookadam, M.D.
Maja Cikes, M.D.
Mayo Clinic
Rochester, MN 55905