Abdominal Bruising (Ecchymosis)

CLINICAL DIAGNOSTIC MANUAL

Abdominal bruising, also known as abdominal ecchymosis, refers to purplish-blue discoloration of the skin due to the accumulation of blood outside the blood vessels, typically caused by trauma or internal bleeding.

This clinical sign can indicate significant hemorrhage within the abdomen and may be a marker of potentially life-threatening conditions that require immediate medical attention. Identifying the underlying cause is crucial for appropriate treatment and the prevention of severe complications.

Pathology	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Retroperitoneal hemorrhage	Abdominal or lumbar pain, abdominal distension, signs of shock, flank bruising (Grey Turner sign), periumbilical ecchymosis (Cullen sign)	Medical history, physical examination, signs of internal bleeding	Abdominal ultrasound, contrast-enhanced CT, complete blood count
Ruptured aortic aneurysm	Sudden, severe abdominal or lumbar pain, palpable abdominal pulse, hypotension, tachycardia, syncope, abdominal ecchymosis	Medical history, physical examination, abdominal pulsation	Contrast-enhanced CT, angiography
Splenic rupture	Left upper quadrant pain, referred pain to the left shoulder (Kehr sign), abdominal tenderness, signs of shock, left flank ecchymosis	Medical history, physical examination, signs of shock	Abdominal ultrasound, contrast-enhanced CT, complete blood count