{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:47:06Z","timestamp":1774882026441,"version":"3.50.1"},"reference-count":7,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ping Tung Christian Hospital","award":["PS115010"],"award-info":[{"award-number":["PS115010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Inguinal ecchymosis, known as Stabler sign, is classically associated with retroperitoneal hemorrhage. However, imaging confirmation of the underlying mechanism is rarely demonstrated. We report a 33-year-old woman who developed progressive right inguinal ecchymosis one week after excisional surgery for fibrocystic breast nodules. Physical examination revealed extensive bruising over the right breast and a separate ecchymotic area in the right inguinal region. Laboratory tests showed mild anemia with stable hemoglobin levels, while coagulation parameters and pancreatic enzymes were normal. Contrast-enhanced computed tomography excluded retroperitoneal or pelvic hemorrhage but revealed a large right breast hematoma. Multiplanar CT reconstructions demonstrated hyperattenuating fluid tracking along the superficial fascial planes of the anterior chest wall and abdominal wall toward the inguinal region. Anatomically, the superficial fascial system comprising Camper\u2019s and Scarpa\u2019s fascia provides a potential pathway for gravity-dependent migration of extraperitoneal blood. This case suggests that inguinal ecchymosis may result from extraperitoneal blood tracking from a distant postoperative hematoma rather than retroperitoneal bleeding.<\/jats:p>","DOI":"10.3390\/diagnostics16070981","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:57:34Z","timestamp":1774447054000},"page":"981","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stabler Sign Secondary to Postoperative Breast Hematoma: CT Evidence of Extraperitoneal Blood Tracking"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8921-2912","authenticated-orcid":false,"given":"Yoen Young","family":"Chuah","sequence":"first","affiliation":[{"name":"Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ping Tung Christian Hospital, Pingtung 90059, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6486-7717","authenticated-orcid":false,"given":"Yeong Yeh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Sheng","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ping Tung Christian Hospital, Pingtung 90059, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0798-5028","authenticated-orcid":false,"given":"Yow-Ling","family":"Shiue","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan"},{"name":"Institute of Biomedical Sciences and College of Medicine, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref_1","first-page":"141","article-title":"Inguinal ecchymosis as a sign of retroperitoneal hemorrhage","volume":"118","author":"Stabler","year":"1976","journal-title":"Radiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1055\/s-2007-995223","article-title":"Stabler\u2019s sign revisited in a spontaneously ruptured neuroblastoma of the newborn","volume":"25","author":"Raveenthiran","year":"2008","journal-title":"Am. J. Perinatol."},{"key":"ref_3","first-page":"1","article-title":"Stabler\u2019s sign: A rare association with portal hypertension","volume":"83","author":"Chuah","year":"2022","journal-title":"Br. J. Hosp. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e437","DOI":"10.1016\/j.amjmed.2022.07.019","article-title":"Cullen Sign and Grey Turner Sign in Acute Pancreatitis","volume":"135","author":"Ganguly","year":"2022","journal-title":"Am. J. Med."},{"key":"ref_5","first-page":"78","article-title":"An unusual cause of Cullen sign: Blunt trauma and ruptured hemorrhagic pancreatic pseudocyst","volume":"52","author":"Chuah","year":"2025","journal-title":"Pan Afr. Med. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"164","DOI":"10.5694\/mja2.50924","article-title":"Cullen and Grey Turner signs in abdominal pain","volume":"214","author":"Chuah","year":"2021","journal-title":"Med. J. Aust."},{"key":"ref_7","first-page":"1","article-title":"An unexpected cause of Cullen\u2019s sign: Rupture of hepatocellular carcinoma","volume":"83","author":"Chuah","year":"2022","journal-title":"Br. J. Hosp. Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/981\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:49:58Z","timestamp":1774878598000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":7,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["diagnostics16070981"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16070981","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]}}}