Cullen's sign

Cullen's sign, also known as umbilical black eye, is superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. It is also known as peri-umbilical ecchymosis.

It is named for gynecologist Thomas Stephen Cullen (1869–1953), who first described the sign in ruptured ectopic pregnancy in 1916.

The finding of Cullen's sign may indicate intra-peritoneal or retroperitoneal hemorrhage. The signs and symptoms include bruising/ecchymosis around the umbilicus and can also include swelling and abdominal pain.

This sign takes 24–48 hours to appear and can predict acute pancreatitis, with mortality rising from 8–10% to 40%. It may be accompanied by Grey Turner's sign (bruising of the flank), which may then be indicative of pancreatic necrosis with retroperitoneal or intra-abdominal bleeding.