Cullen's sign is bruising around which location?

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Cullen's sign is bruising around the umbilicus, a periumbilical ecchymosis that signals intra-abdominal bleeding. Blood from intra-abdominal processes can track along the falciform ligament to the umbilical area, producing this bruising. It’s classically described with acute pancreatitis or a ruptured ectopic pregnancy, but it can occur with other intra-abdominal hemorrhages as well. The other options don’t fit because bruising in the flank describes Grey Turner's sign (retroperitoneal bleeding), while pain in the right lower quadrant or nausea are symptoms rather than a localized bruising sign. Keep in mind Cullen’s sign is a late, non-specific finding, so its presence should heighten suspicion for intra-abdominal bleeding but it isn’t solely diagnostic.