In acute pancreatitis, the overflowing pancreatic juice contains a large amount of pancreatic enzymes that spread along the tissue interstitial space and leak under the skin to dissolve the subcutaneous fat, causing the capillaries to rupture and bleed, and the skin around the umbilicus appears blue-purple called Cullen’s sign. How to diagnose cyanosis of the skin around the umbilicus? In addition to purple skin around the umbilicus and lateral abdominal wall, there can also be skin damage on the extremities in the form of purple spots, blisters and necrosis, and skin damage is one of the signs of critical condition. The abdominal wall manifestations of acute pancreatitis are part of the systemic disease, and signs and symptoms such as abdominal wall edema, pressure pain and skin color change can be seen clinically. Most acute pancreatitis has a sudden onset and manifests as severe epigastric pain that radiates to the back of the shoulder, and the patient feels a girdling sensation in the upper abdomen and lower back. The location of abdominal pain is related to the location of the lesion, for example, if the lesion in the head of the pancreas is heavy, the abdominal pain is mainly in the right upper abdomen and radiates to the right shoulder; if the lesion is in the tail of the pancreas, the abdominal pain is heavy in the left upper abdomen and radiates to the left shoulder. The intensity of pain is consistent with the extent of the lesion. If it is edematous pancreatitis, the abdominal pain is persistent with paroxysmal aggravation, and can be relieved by acupuncture or injection of antispasmodic drugs; if it is hemorrhagic pancreatitis, the abdominal pain is very intense, often accompanied by shock, and it is difficult to stop the pain with the usual pain relief methods. The first onset of the disease is characterized by the inability to relieve abdominal pain after vomiting. The frequency of vomiting is also consistent with the severity of the lesion. In edematous pancreatitis, there is not only nausea, but also vomiting 1 to 3 times; in hemorrhagic pancreatitis, the vomiting is intense or continuous and frequent dry vomiting. There may be fever, jaundice, etc. The degree of fever is consistent with the severity of the lesion. In edematous pancreatitis, there may be no fever or only mild fever; in hemorrhagic necrotizing pancreatitis, there may be high fever, and if the fever does not subside, there may be complications, such as pancreatic abscess. Jaundice may occur as a complication of biliary tract disease or due to compression of the common bile duct by the enlarged pancreatic head.