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Cullen's sign....virchow's gland and calcified pericardium..

Has been an interesting one month.I am getting to see some text book cases which I have never seen in my twenty years of practise. The other day I saw a lady who had a palpable Virchow's gland with Cullen's sign .She has been sent for lymph node biopsy and a CT Chest and abdomen.

The lady had been admitted with very severe jaundice and altered sensorium but turned out to have Scrub typhus .She responded well to Doxycycline.The jaundice cleared and she hop-skipped into the OPD for a review.She was eating well and looking well so I thought I would have a quick lookover although she was asymptomatic.I had suspected something may be amiss while she was admitted and had requested a colleague to do an USG since her jaundice was predominantly direct hyperbilirubinemia .It did not flag a concern but this morning I decided to review the case in detail before I gave her a thumbs up sign and there it was two sinister looking markers defying all clinical status.It was my first Cullen's sign in my twenty years carrier.

I have also been seeing a spate of pericardial effusions with features of constrictive pericardites.Saw a few calcified pericardiums which I had seen last during my post-graduate days in Oddanchattram.The wealth of cases that come in .

I need to be more vigilant about recording some of the findings.

Spent the morning talking to my dear cousin in New Zealand .She had a harvest of turmeric from a few pieces she had planted carelessly. It was lovely catching up with her.


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