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It is named for Thomas S. Cullen (1869-1953),[1] who was an obstetrician and first described the
sign in ruptured ectopic pregnancy in 1916.[2]
This sign takes 24-48 hours to appear and predicts a severe attack of acute pancreatitis, with
mortality rising from 8-10% to 40%.
It may be accompanied by Grey Turner's sign[3] (bruising of the flank), which may then be
indicative of Pancreatic necrosis with retroperitoneal or intraabdominal bleeding.
Causes
Causes include:
• acute pancreatitis, where methaemalbumin formed from digested blood tracks around the
abdomen from the inflamed pancreas
• bleeding from blunt abdominal trauma
• bleeding from ruptured abdominal aortic aneurysm
• bleeding from ruptured ectopic pregnancy