Caput medusae - Misplaced Pages

(Redirected from Caput medusa) Appearance of distended and engorged superficial epigastric veins For the cactus, see Astrophytum caput-medusae.

Medical condition

Caput medusae
Other names	Palm tree sign

Axial CT showing portosystemic collateral circulation via the umbilical vein: caput medusae in liver cirrhosis
Specialty	Gastroenterology

Caput medusae is the appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. The name caput medusae (Latin for "head of Medusa") originates from the apparent similarity to Medusa's head, which had venomous snakes in place of hair. It is also a sign of portal hypertension. When the portal vein, that transfers the blood from the gastrointestinal tract to the liver, is blocked, the blood volume increases in the peripheral blood vessels making them appear engorged. It is caused by dilation of the paraumbilical veins, which carry oxygenated blood from mother to fetus in utero and normally close within one week of birth, becoming re-canalised due to portal hypertension caused by liver failure.The appearance is due to cutanous portosystemic collateral formation between distended and engorged paraumbilical veins that radiate from the umbilicus across the abdomen to join systemic veins.

Differential diagnosis

Inferior vena cava obstruction

Produces abdominal collateral veins to bypass the blocked inferior vena cava and permit venous return from the legs.

Determine the direction of flow in the veins below the umbilicus. After pushing down on the prominent vein, blood will:

flow toward the legs → caput medusae
flow toward the head → inferior vena cava obstruction.
Color Doppler ultrasonography is used to differentiate between vena cava obstruction and portal hypertension

References

Mohammed AA (June 2020). "Caput medusae sign; a unique finding during abdominal examination in patients with portal hypertension; case report". Annals of Medicine and Surgery. 54: 54–56. doi:10.1016/j.amsu.2020.04.004. PMC 7191313. PMID 32373342.
https://www.webmd.com/digestive-disorders/what-is-caput-medusae
Sharma B, Raina S (April 2015). "Caput medusae". The Indian Journal of Medical Research. 141 (4): 494. doi:10.4103/0971-5916.159322. PMC 4510739. PMID 26112857.
Liu CH, Hsu CH (September 2011). "Caput medusae". Clinical Gastroenterology and Hepatology. 9 (9): A26. doi:10.1016/j.cgh.2011.03.035. PMID 21565282.
Chaurasia BD (2023). "Chapter 21: Large Blood Vessels of the Gut". Human Anatomy (Ninth ed.). CBS Publishers & Distributors Pvt Ltd. ISBN 978-93-5466-476-2.

External links

Classification	D ICD-10: I86.8 (ILDS I86.820) ICD-9-CM: 456.8

Cardiovascular disease (vessels)

Arteries, arterioles
and capillaries

Inflammation	Arteritis Aortitis Buerger's disease
Arteriosclerosis	Atherosclerosis Foam cell Fatty streak Atheroma Cholesterol LDL Oxycholesterol Trans fat Monckeberg's arteriosclerosis Hyaline arteriolosclerosis Hyperplastic arteriolosclerosis
Peripheral artery disease	Stenosis Carotid artery stenosis Renal artery stenosis Aortoiliac occlusive disease Critical limb ischemia Degos disease Erythromelalgia Fibromuscular dysplasia Hepatic artery thrombosis Intermittent claudication Raynaud's phenomenon
Aneurysm / dissection / pseudoaneurysm	torso: Aortic aneurysm Abdominal aortic aneurysm Thoracic aortic aneurysm Aneurysm of sinus of Valsalva Aortic dissection Aortic rupture Coronary artery aneurysm head / neck Intracranial aneurysm Intracranial berry aneurysm Carotid artery dissection Vertebral artery dissection Familial aortic dissection
Vascular malformation	Arteriovenous fistula Arteriovenous malformation Telangiectasia Hereditary hemorrhagic telangiectasia Generalized essential telangiectasia
Vascular nevus	Cherry hemangioma Halo nevus Spider angioma

Veins

Inflammation	Phlebitis
Venous thrombosis / Thrombophlebitis	primarily lower limb Deep vein thrombosis abdomen Hepatic veno-occlusive disease Budd–Chiari syndrome May–Thurner syndrome Portal vein thrombosis Renal vein thrombosis upper limb / torso Mondor's disease Paget–Schroetter disease Pulmonary embolism head Cerebral venous sinus thrombosis Post-thrombotic syndrome
Varicose veins	Gastric varices Portacaval anastomosis Caput medusae Esophageal varices Hemorrhoid Varicocele
Other	Chronic venous insufficiency Chronic cerebrospinal venous insufficiency Superior vena cava syndrome Inferior vena cava syndrome Venous ulcer

Arteries or veins

Blood pressure

Hypertension	Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension
Hypotension	Orthostatic hypotension Shock (circulatory)

Categories:

Differential diagnosis

Inferior vena cava obstruction

See also

References

External links