Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report
Introduction: Cullen sign is an area of periumbilical ecchymosis that results from blood tracking along the round ligament. Any source of retroperitoneal or abdominal hemorrhage can cause Cullen sign, but it is often described in association with acute pancreatitis. Case Report: Here we report a cas...
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eScholarship Publishing, University of California
2025-01-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
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| author | Kendra M. Douglas William R. Davis Jaron D. Raper |
| author_facet | Kendra M. Douglas William R. Davis Jaron D. Raper |
| author_sort | Kendra M. Douglas |
| collection | DOAJ |
| description | Introduction: Cullen sign is an area of periumbilical ecchymosis that results from blood tracking along the round ligament. Any source of retroperitoneal or abdominal hemorrhage can cause Cullen sign, but it is often described in association with acute pancreatitis. Case Report: Here we report a case of a chronically ill male who presented with a bulging sensation in his lower abdomen and lower abdominal pain. On physical examination this patient was noted to have a large area of periumbilical ecchymosis predominantly on the left aspect of the umbilicus, consistent with Cullen sign. Computed tomography abdomen and pelvis were remarkable for an enlarging left external iliac artery aneurysm with adjacent hematoma and multifocal intraperitoneal hematoma tracking into the right side of the abdomen, concerning for aneurysmal rupture. The patient was taken to the operating room for a left iliac artery arteriogram and stent placement. Conclusion: Isolated iliac artery aneurysms are rare and represent less than 2% of all abdominal aneurysmal disease; furthermore, external iliac artery aneurysms are exceedingly rare and account for the least common abdominal aneurysmal pathology. This case demonstrates the importance of considering other etiologies of Cullen sign beyond pancreatitis, including aneurysmal ruptures. |
| format | Article |
| id | doaj-art-ee645bb33e1c46cba83a984ada4a5eb5 |
| institution | Kabale University |
| issn | 2474-252X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | eScholarship Publishing, University of California |
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| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-ee645bb33e1c46cba83a984ada4a5eb52025-02-04T17:35:19ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-01-0191333610.5811/cpcem.24997cpcem-9-33Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case ReportKendra M. Douglas0William R. Davis1Jaron D. Raper2University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, AlabamaUniversity of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, AlabamaUniversity of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, AlabamaIntroduction: Cullen sign is an area of periumbilical ecchymosis that results from blood tracking along the round ligament. Any source of retroperitoneal or abdominal hemorrhage can cause Cullen sign, but it is often described in association with acute pancreatitis. Case Report: Here we report a case of a chronically ill male who presented with a bulging sensation in his lower abdomen and lower abdominal pain. On physical examination this patient was noted to have a large area of periumbilical ecchymosis predominantly on the left aspect of the umbilicus, consistent with Cullen sign. Computed tomography abdomen and pelvis were remarkable for an enlarging left external iliac artery aneurysm with adjacent hematoma and multifocal intraperitoneal hematoma tracking into the right side of the abdomen, concerning for aneurysmal rupture. The patient was taken to the operating room for a left iliac artery arteriogram and stent placement. Conclusion: Isolated iliac artery aneurysms are rare and represent less than 2% of all abdominal aneurysmal disease; furthermore, external iliac artery aneurysms are exceedingly rare and account for the least common abdominal aneurysmal pathology. This case demonstrates the importance of considering other etiologies of Cullen sign beyond pancreatitis, including aneurysmal ruptures.https://escholarship.org/uc/item/0zt8q0b0 |
| spellingShingle | Kendra M. Douglas William R. Davis Jaron D. Raper Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report Clinical Practice and Cases in Emergency Medicine |
| title | Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report |
| title_full | Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report |
| title_fullStr | Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report |
| title_full_unstemmed | Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report |
| title_short | Cullen Sign Associated with External Iliac Artery Aneurysm Rupture: A Case Report |
| title_sort | cullen sign associated with external iliac artery aneurysm rupture a case report |
| url | https://escholarship.org/uc/item/0zt8q0b0 |
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