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/dl.

又是怪怪的圖..在肚臍周圍出現一圈ecchymoses..在軀幹的兩側有有類似的瘀青..

以abdominal CT掃描,證實為retroperitoneal hemorrhage..

Cullen's sign的起因為後腹腔出血,沿著falciform ligament(鐮狀韌帶)流到肚臍附近的皮下組織..

Turner's sign的起因為出血自posterior pararenal space流至quadratus lumborum muscle的兩側..

早就1919年..Thomas. S. Cullen (1869-1953)提出了第一個因為etopic prgnancy repture出現這樣病徵的病例..

在acute pancreatitis,大約只有3%病患會生這樣的病徵..一旦發生這樣的病徵..死亡率約為40%

Adapted from N Engl J Med. 2005; 353: 1386.