• Inspect the abdomen for signs of trauma such as ecchymosis across the abdominal area. Look for Cullen's sign and Grey-Turner's sign–both of these indicate retroperitoneal hemorrhage. Cullen's sign is bruising around the umbilicus (Figure 1). Grey-Turner's sign is bruising along the flank and indicates blunt force hemorrhage, aortic leaking and pancreas or kidney bleeding2 (Figure 2).