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Visual Diagnosis # 16


This 48 yr old male presented to the emergency department with severe mid-epigastric pain worsening over the past 3 days. He describes associated nausea and vomiting without diarrhea or fever. No urinary symptoms. He admits to daily tobacco and alcohol use. He denies any recent illnesses or trauma. His abdominal exam is diffusely tender and slightly distended with associated rebound and guarding. You also note some mild periumbilical ecchymosis. 


Cullen's sign 2 - 60secondEM



What is this sign called ?

What are the two most common conditions this sign might indicate?

What are some other common signs that be be associated with these conditions?









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