Which sign is classically associated with retroperitoneal hemorrhage?

• A. Cullen's sign
• B. Grey Turner's sign
• C. Ecchymosis
• D. Mottling

Answer: (B)

Grey Turner's sign is the flank bruising that indicates a retroperitoneal bleed. Blood from a retroperitoneal hemorrhage can track along tissue planes to the flanks, producing ecchymosis that may appear hours to days after the injury. This localization to the flanks makes it the classic sign of retroperitoneal bleeding.

Cullen's sign, by contrast, is periumbilical ecchymosis seen with intraperitoneal bleeding, such as from pancreatitis or ruptured ectopic pregnancy. General ecchymosis is just bruising anywhere and isn’t specific to the retroperitoneum. Mottling refers to patchy skin discoloration due to poor perfusion in shock, not a sign of retroperitoneal bleeding.