You may redistribute it, verbatim or modified, providing that you comply with the terms of the GFDL. It describes the appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to join the systemic veins. Dilated tortuous superficial epigastric veins (caput medusae, figure 1) were noted above the umbilicus . Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. This content requires an NEJM.org account. Betty Radice. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery. It is mandatory to procure user consent prior to running these cookies on your website. Berzigotti A, Piscaglia F; EFSUMB Education and Professional Standards Committee. official website and that any information you provide is encrypted Ultrasound in portal hypertension--part 2--and EFSUMB recommendations for the performance and reporting of ultrasound examinations in portal hypertension. Who's Who in the Ancient World. The serpentine appearance of these dilated veins resemble the head (caput, Latin) of the mythical gorgon of Greek mythology, Medusa, whose golden wavy hair were turned into living snakes by Athenas curse; and hence the name caput medusae.2 Cruveilhier-Baumgarten syndrome is a clinical entity characterised by the presence of unusually prominent . The caput medusae sign is seen in patients with severe portal hypertension. ADVERTISEMENT: Supporters see fewer/no ads. The caput medusae sign in portal hypertension. The inflamed veins are called paraumbilical veins. Federal government websites often end in .gov or .mil. So far, none of the onlookers have turned into stone! [Imaging of collaterals and their impact on portal venous flow in patients with liver cirrhosis]. Author S M Cohen 1 Affiliation 1 Digestive Care Associates, Peoria, IL 61603, USA. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. official website and that any information you provide is encrypted Caput medusae is the appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. Pei-Ming Yang, M.D., Ph.D., and Ding-Shinn Chen, M.D. A). Embolization or transjugular intrahepatic portosystemic shunt may be . Cho K, Patel Y, Wachsberg R, Seeff J. Varices in Portal Hypertension: Evaluation with CT. Radiographics. Varicose Veins / etiology* A 47-year-old man with a seven-year history of compensated hepatic cirrhosis due to chronic hepatitis B infection presented for . In cases of liver cirrhosis (usually discreet), Budd-Chiari syndrome, pelvic vein thrombosis. An official website of the United States government. Unable to process the form. Physical examination revealed a firm liver and mild splenomegaly. The paraumbilical veins are thick-walled and . On examination she had spider angiomas, a palpable firm left lobe of the liver and clubbing. 2004 Nov;16(12):1339-45. doi: 10.1097/00042737-200412000-00018. The caput medusae sign is seen in patients with severe portal hypertension. This page contains content from the copyrighted Wikipedia article "Caput medusae"; that content is used under the GNU Free Documentation License (GFDL). Color Doppler ultrasonography is a convenient, noninvasive method for determining the course and associated hemodynamic changes in the paraumbilical collateral circulation. Turbulent flow was seen at the junction between inferior epigastric and external iliac veins, paraumbilical and superficial epigastric veins, and superficial epigastric and saphenous veins in some patients. As for light and air, it does very well in indirect sunlight and prefers a bit of air circulation. Accessed 20 Dec 2017, Section of Radiological Sciences, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy, Dario Giambelluca,Giovanni Caruana,Roberto Cannella,Dario Picone&Massimo Midiri, You can also search for this author in PubMedGoogle Scholar. Soakings and heavy mistings must be done with care to avoid rotting. DOI: 10.1056/NEJMicm050651. A 47-year-old man with a seven-year history of compensated hepatic cirrhosis due to chronic hepatitis B infection presented for routine evaluation. The caput medusae sign is seen in patients with severe portal hypertension. Sign of portal hypertension. Embolization or transjugular intrahepatic portosystemic shunt may be used to decompress the collateral route in cases of hemorrhage. Already have an account? There were mildly tortuous veins on his abdominal wall, especially above the umbilicus. When this occurs, there can be an externally visible dilation of the paraumbilical (and perhaps even the thoracoepigastric veins) which leads to the appearance of "Caput Medusae". . The name caput medusae (Latin for "head of Medusa") originates from the apparent similarity to Medusa's hair once Minerva had turned it into snakes. (2007) ISBN: 9780553590128 -, bunch of grapes sign (botryoid rhabdomyosarcoma), bunch of grapes sign (intracranial tuberculoma), bunch of grapes sign (intraosseous hemangiomas), bunch of grapes sign (multicystic dysplastic kidney). https://doi.org/10.1007/s00261-018-1493-4, https://doi.org/10.1148/radiographics.15.3.7624566, https://doi.org/10.1148/radiology.207.3.9609879, https://commons.wikimedia.org/wiki/File:Medusa_by_Caravaggio_2.jpg. Portal circulation is the flow of blood from one organ to another without going through the heart. An official website of the United States government. MeSH https://commons.wikimedia.org/wiki/File:Medusa_by_Caravaggio_2.jpg. Vestn Rentgenol Radiol. Anastomosis between the veins of the anterior abdominal wall and the hepatic portal, hypogastric, and iliac veins. The https:// ensures that you are connecting to the Turbulent flow was seen at the junction between inferior epigastric and external iliac veins, paraumbilical and superficial epigastric veins, and superficial epigastric and saphenous veins in some patients. What are Paraumbilical veins?.2. Clipboard, Search History, and several other advanced features are temporarily unavailable. The Greek Myths. Part of Springer Nature. Caput medusae sign - portal hypertension. The condition of Caput Medusae occurs due to portal hypertension. Caput medusae also known as palm tree sign is the appearance of distended and engorged paraumbilical veins which are seen radiating from the umbilicus across the abdomen to join systemic veins. This sign takes its name from Type 4 (11.1%) is a combination of types 1 and 2. The site is secure. Under increased portal pressure it is thought that the veins around the obliterated umbilical vein, the paraumbilical veins, become distended and carry the blood the paraumbilical veins through the lfalciform ligament. Medusa was encountered and beheaded by the Greek demigod hero Perseus 2,3. The content is copyrighted to The Meaning and may not be reproduced on other websites. What are Paraumbilical veins?.2. Epub 2012 Feb 9. Portacaval anastomosis - Paraumbilical vein - Cirrhosis - Liver failure - Navel - Latin - Medusa - Portal hypertension - In utero - Abdomen - Inferior vena cava - Leg - The International League of Dermatological Societies - Gastroenterology - Splenomegaly - Index of anatomy articles - Chronic liver disease - Developmental venous anomaly - Central nervous system cavernous hemangioma - Round . PubMed Central A 57-year-old female with significant alcohol exposure, hepatitis C and liver cirrhosis was admitted for management of dehydration and anaemia. volume43,pages 25352536 (2018)Cite this article. The veins are twisted and appear to be stemming out in all directions from the umbilicus (commonly known as the belly button). Gastrointestinal Motility and Functional Bowel Disorders. https://doi.org/10.1148/radiology.207.3.9609879, Douglas JG (1981) Umbilical haemorrhagean unusual complication of cirrhosis. It describes engorged paraumbilical veins radiating from the umbilicus within the adipose tissue of the anterior abdominal wall, creating portosystemic anastomoses [].This sign takes its name from Medusa, the mythological gorgon of Greek mythology, generally . Please enable it to take advantage of the complete set of features! about navigating our updated article layout. The appearance of swollen veins in the abdominal area is not a common occurrence. PMC Careers, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA. Paraumbilical veins (portal) -> epigastric veins (systemic) . It is a unique system of veins that transfers nutrients from the gut, pancreas and spleen to the liver. The site is secure. The superior vein of Sappey drains the upper portion of the falciform ligament and medial part of the diaphragm and enters peripheral portal . Create a free account now. Information and tools for librarians about site license offerings. This website uses cookies to improve your experience while you navigate through the website. The umbilical vein carries oxygenated blood from mother to fetus in utero, and normally closes within one week of birth. Abdom Radiol 43, 25352536 (2018). Bethesda, MD 20894, Web Policies These cookies do not store any personal information. Caput Medusae. will also be available for a limited time. Caput Medusae is a medical condition that refers to the appearance of swollen veins on the abdomen. We'll assume you're ok with this, but you can opt-out if you wish. A frank caput medusa was not seen, but occult caput medusa were seen in two patients. A review of the patient's recent CT of the abdomen revealed a large recanalised paraumbilical vein (figure 2) originating from the left side of the portal vein. https://en.wikipedia.org/wiki/Caput_medusae, http://www.rightdiagnosis.com/symptoms/caput_medusae/causes.htm, http://onlinelibrary.wiley.com/doi/10.1111/jgh.12802/pdf, https://www.hopkinsmedicine.org/gastroenterology_hepatology/_pdfs/liver/portal_hypertension.pdf, Causes of Numbness and Tingling (Paresthesia) in, Swelling of the legs and belly due to fluid build-up in the body, Humming sound of the blood passing and the sound becomes louder while breathing, Thorough checking of the individuals medical background. In type 2 (3.7%), the vein connected with the saphenous vein via the superficial epigastric vein. This section has been translated automatically. These cookies will be stored in your browser only with your consent. This section has been translated automatically. Postgrad Med J 57:461462, Article Accessibility Caput medusae may be left alone. government site. From here the blood flows to the system of the inferior vena . Knowledge of the other collaterals is essential since they may undergo spontaneous hemorrhage or bleeding from disruption of these vessels during surgical procedures.1 They also had lesser episodes of bleeding from esophageal varices. sharing sensitive information, make sure youre on a federal The best marked of these small veins is one which commences at the umbilicus and runs backward and upward . Caput medusae are a network of dilated veins around the umbilicus and are one of the manifestations of portal hypertension from cirrhosis of the liver. and transmitted securely. 2022 Springer Nature Switzerland AG. PubMed Gross anatomy. At times this could be mistaken for paraumbilical hernia. The .gov means its official. The Left gastric vein feeds into the portal system, while the Esophageal veins feed into the systemic circulation. doi:10.1111 . PMID: 10432326 DOI: 10.1056/NEJM199908053410605 No abstract available . . sharing sensitive information, make sure youre on a federal Caput medusa is a frequent incidental finding in patients with portal hypertension that usually represents paraumbilical . The most trusted, influential source of new medical knowledge and clinical best practices in the world. The content of this site is intended for health care professionals. On examination she had spider angiomas, a palpable firm left lobe of the liver and clubbing. The term is Latin for Head of Medusa and originates from its similarity to Medusas hair. A frank caput medusa was not seen, but occult caput medusa were seen in two patients. Caput medusae are a network of dilated veins around the umbilicus and are one of the manifestations of portal hypertension from cirrhosis of the liver. Anatomical basis of Caput Medusae/ Palm Tree sign.Share, Support, Subscribe!!! Correspondence to In the course of the round ligament of liver, small veins ( paraumbilical) are found which establish an anastomosis between the veins of the anterior abdominal wall and the hepatic portal, hypogastric, and iliac veins . For further evaluation of the same, a multiphase CT was performed, which showed evidence of cirrhosis with portal hypertension. National Library of Medicine https://doi.org/10.1148/radiographics.15.3.7624566, Article Loaded in 0.055 seconds / 17 queries. Would you like email updates of new search results? Valuable tools for building a rewarding career in health care. (B). 1. HHS Vulnerability Disclosure, Help Axial computed tomography (CT) abdomen showing subcutaneous collateral veins on the anterior abdominal wall communicating with umbilical . A review of the patient's recent CT of the abdomen revealed a large recanalised paraumbilical vein (figure 2) originating from the left side of the portal vein.It coursed through the falciform ligament towards the epigastric abdominal wall to empty into a large varix (figure 2).Superior and inferior epigastric veins from the varix then drained into the axillary and femoral veins, respectively . The appearance is reminiscent of the hair of . Treating such a situation with neglect may result in further health complications. A 48-year-old woman who was initially diagnosed with Hepatitis C, subsequently developed compensated cirrhosis of liver and portal hypertension with a complication of hepatocellular carcinoma. 10.1002/(SICI)1097-0096(199609)24:7<359::AID-JCU6>3.0.CO;2-A. The veins swell or the fluids, water or blood in them may cause further swelling. CB syndrome represents spontaneous portosystemic collateralization between the paraumbilical vein and the veins of the anterior abdominal wall in a patient with portal hypertension. . 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. While it's not a disease, it is a sign of an . Robert Graves. The authors declare that they have no conflict of interests. Portocaval anatomosis.3. A 57-year-old female with significant alcohol exposure, hepatitis C and liver cirrhosis was admitted for management of dehydration and anaemia. 2. Youtube: http://w. We also use third-party cookies that help us analyze and understand how you use this website. Similar swelling can occur in other parts of the body such as around the rectum, the meeting point of the esophagus and the stomach. It is also a sign of portal hypertension. Caput medusae Nishith K Singh, Usman The condition of Caput Medusae occurs due to portal hypertension. Morin C, Lafortune M, Pomier G, Robin M, Breton G. Radiology. The Statement of informed consent was not applicable since the manuscript does not contain any patient data. Learn more 1995;15(3):609-22. The inflamed veins are called paraumbilical veins. Giambelluca, D., Caruana, G., Cannella, R. et al. CT scan and reconstructed venogram showed a dilated paraumbilical vein (b, thin arrow) and a varicose periumbilical vein (b, thick arrow). A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making. This site needs JavaScript to work properly. Download scientific diagram | CT without contrast (axial) shows protruding paraumbilical veins from publication: A case of fatal cutaneous caput medusae hemorrhage | Key Clinical Message Alcoholic . The veins swell or the fluids, water or blood in them may cause further swelling. Bypass circulation via the paraumbilical veins in cases of venous congestion in . The new PMC design is here! into the abdominal wall veins creates the murmur.2. Dilatation of the abdominal skin veins, especially the paraumbilical veins. Caput medusae, also known as palm tree sign, is the appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to join systemic veins.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. The appearance is reminiscent of the hair of Medusa, one of the three Gorgons of Greek mythology. 1. 2008 Jan-Feb;(1):36-9. The most advanced way to teach, practice, and assess clinical reasoning skills. Type 4 (11.1%) is a combination of types 1 and 2. This category only includes cookies that ensures basic functionalities and security features of the website. Answer: Let me know if I don't quite answer your question, but a simple way to think about it would be that any condition which both: 1. Youtube: http://www.youtube.com/c/AnatomyClassesbyDrSushant Twitter: https://twitter.com/anatomy_classesFacebook: https://www.facebook.com/AnatomyClasssesByDrSushantInstagram: https://www.instagram.com/anatomyclassesbydrsushantTelegram: https://t.me/anatomyclassesbydrsushantAbout : Anatomy Classes By Dr. Sushant is a YouTube Channel, where you will find anatomy videos in english :) Cruveilhier-Baumgarten (CB) syndrome, described by Cruveilhier (1835) and Baumgarten (1908), refers to a murmur over the umbilicus often in the presence of caput medusae, resulting from portal hypertension, usually with hepatic cirrhosis. The Gorgons had venomous snakes for hair and their countenance was said to be so terrifying that anyone who looked upon them was literally turned to stone. PMC legacy view Swollen veins on the anterior abdominal wall (sometimes referred to as caput medusae). Check for errors and try again. Bethesda, MD 20894, Web Policies FOIA Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in 1. . The name caput medusae (Latin for head of Medusa) originates from the apparent similarity to Medusas head which had venomous snakes in place of hair.The umbilical vein carries oxygenated blood from mother to fetus in utero and normally closes within one week of birth. Pei-Ming Yang, M.D., Ph.D.Ding-Shinn Chen, M.D.National Taiwan University Hospital, Taipei 100, Taiwan, November 24, 2005N Engl J Med 2005; 353:e19 In portal hypertension, the umbilical vein can become re-canalized. This website uses cookies to improve your experience. Radiology 207:599600. Impact of spider nevus and subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis. Before The distension of the left portal vein had created a portosystemic shunt and periumbilical vein dilatation (c). Information, resources, and support needed to approach rotations - and life as a resident. This article does not contain any studies with human participants or animals performed by any of the authors. What are the implications of the abnormality and treatment options? It is caused by dilation of the paraumbilical . Dario Giambelluca. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. During portal circulation, the pressure is extremely high. Signs and symptoms are varicose veins on the abdominal wall called caput medusae, oesophageal varices, enlargement of the spleen, accumulation of fluid in the peritoneal cavity and bleeding in the gastrointestinal tract. Dilation of this particular portacaval anastomosis results in what is referred to as caput medusae. This is a preview of subscription content, access via your institution. Bookshelf A small portion of the umbilical vein at its junction with the left portal vein may remain patent throughout life. (2017) ISBN: 9780241982358 -, 3. It describes engorged paraumbilical veins radiating from the umbilicus within the adipose tissue of the anterior abdominal wall, creating por-tosystemic anastomoses [1]. - 103.147.92.12. Caput medusae are the radiating veins around umbilicus and is a sign of portal. Large caput medusae over anterior abdomen wall. Appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. In the periumbilical region were distended superficial veins similar in appearance to caput medusae, but without any bruit around the umbilicus. Public domain. Postprandial splanchnic haemodynamic changes in patients with liver cirrhosis and patent paraumbilical vein. Origin: arise from cutaneous veins around the umbilicus running along the round ligament of the liver, and terminating as accessory portal veins in its substance; they constitute a portocaval anastomosis and are subject to varicosity during portal hypertension; varicose paraumbilical veins form the caput medusae. John C. Traupman. Stay connected to what's important in medical research and clinical practice, Subscribe to the most trusted and influential source ofmedical knowledge. Berzigotti A, Dapporto S, Angeloni L, Ramilli S, Bianchi G, Morelli MC, Magalotti D, Zoli M. Eur J Gastroenterol Hepatol. Embryologically, the left umbilical vein undergoes gradual atrophy to form the ligamentum teres in the falciform ligament. When proper blood flow is difficult, the body attempts at opening an alternative arrangement of veins by a build-up of pressure, thus resulting in the swelling of the veins that appear on the abdomen. Leaves the para-umbilicals in continuity with the increased pressure, should manifest the condition. Before Portal circulation is the flow of blood from one organ to another without going through the heart. The Tillandsia Caput Medusae does not require any soakings, and prefers to be misted 2-3 times a week. Breakthrough Infections after Postexposure Vaccination against Mpox, Efficacy of Antiviral Agents against Omicron Subvariants BQ.1.1 and XBB, Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus, Tecovirimat for Monkeypox in Central African Republic under Expanded Access, Tumor-Infiltrating Lymphocyte Therapy or Ipilimumab in Advanced Melanoma, Case 37-2022: A 55-Year-Old Man with Fatigue, Weight Loss, and Pulmonary Nodules, NEJM Catalyst Innovations in Care Delivery. CAS Recanalization of the umbilical vein with reverse blood flow from the liver CAS 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 . She was noted to have massive splenomegaly, without hepatomegaly, hepatic bruit, ascites or pedal edema. Downloaded from Images in. Paraumbilical vein in the cirrhotic patient: imaging with 3D CT angiography. Caput is the Latin for head, and the sign literally translates as head of Medusa 4. What is the diagnosis if there was an additional finding of a bruit around the umbilical area. The CT of the abdomen is as shown in Images 1 and 2. government site. She presented to the hospital with lower abdominal pain. Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with NEJM Group information and services. The https:// ensures that you are connecting to the The authorized source of trusted medical research and education for the Chinese-language medical community. Paraumbilical vein. Caput medusae also known as palm tree sign is the appearance of distended and engorged paraumbilical veins which are seen radiating from the umbilicus across the abdomen to join systemic veins. The Bantam New College Latin & English Dictionary. 8600 Rockville Pike Google Scholar, Philips CA, Arora A, Shetty R, Kasana V (2016) A comprehensive review of portosystemic collaterals in cirrhosis: historical aspects, anatomy, and classifications. Caput is the Latin for head, and the sign literally translates as head of Medusa 4.. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Reference article, Radiopaedia.org (Accessed on 07 Dec 2022) https://doi.org/10.53347/rID-23436, caput medusae sign (developmental venous anomal, bucket handle appearance (disambiguation), bucket handle fracture - non-accidental injury, cockade sign (aorto-left ventricular tunnel), cockade sign (hypertrophic pyloric stenosis), corkscrew sign (diffuse esophageal spasm), hockey stick sign (Creutzfeldt-Jakob disease), light bulb sign (posterior shoulder dislocation), stepladder sign (intracapsular breast implant rupture), stepladder sign (small bowel obstruction), eccentric target sign (cerebral toxoplasmosis), trident sign (persistent primitive trigeminal artery), ginkgo leaf sign (subcutaneous emphysema), chronic inflammatory demyelinating polyneuropathies, salt and pepper sign (vertebral hemangioma), teardrop sign (inferior orbital wall fracture), teardrop sign (intracapsular breast implant rupture), snake-eye appearance (cervical spinal cord), butterfly shape of the grey matter of the spinal cord, caput medusae sign (developmental venous anomaly), doughnut sign (missed testicular torsion), ice cream cone sign (middle ear ossicles), ice cream cone sign (vestibular schwannoma), in total anomalous pulmonary venous return, Caput medusae sign on portal hypertension, Caput medusae sign with portal hypertension, Caput medusae sign due to portal hypertension. Distended and engorged paraumbilical veins which are seen radiating from the umbilicus across the abdomen to join systemic veins. The "caput medusae" sign is a clinical and radiological finding, which can be detected in patients with severe portal hypertension. https://doi.org/10.1007/s00261-018-1493-4, DOI: https://doi.org/10.1007/s00261-018-1493-4. The paraumbilical veins are small veins around the falciform ligament that drain venous blood from the anterior part of the abdominal wall and diaphragm directly into the liver and communicate with other anterior abdominal wall veins 1,2.. National Library of Medicine, Southern Illinois University School of Medicine, Illinois... 9780241982358 -, 3 around the umbilical area the inferior vena Internal Medicine Springfield. 20894, Web Policies these cookies will be stored in your browser only with your wheel. Patel Y, Wachsberg R, Seeff J. Varices in portal hypertension engaging for. Is the diagnosis if there was an additional finding of a bruit around the umbilical area beheaded the... Sometimes referred to as caput medusae are the radiating veins around umbilicus and a! The implications of the onlookers have turned into stone best practices in the falciform ligament and medial of. Several other advanced features are temporarily unavailable medusa and originates from its similarity Medusas... Originates from its similarity to Medusas hair Lafortune M, Breton G..... Further swelling showing subcutaneous collateral vessel of chest/abdominal wall on outcomes of liver cirrhosis ( usually discreet ) the. Medusae occurs due to chronic hepatitis B infection presented for a firm liver and clubbing,! Undergoes gradual atrophy to form the ligamentum teres in the paraumbilical collateral circulation this website uses cookies to your... To join systemic veins of collaterals and their impact on portal venous flow in patients liver. The ligamentum teres in the world she was noted to have massive splenomegaly, hepatomegaly. What 's important in medical research and fresh, bold ideas in clinical trial design and clinical best in! She presented to the liver and mild splenomegaly of dehydration and anaemia appearance is reminiscent of the and! Indirect sunlight and prefers a bit of air circulation patent paraumbilical vein and prepare for board exams Caruana. A preview of subscription content, access via your institution Varices in portal hypertension Chen. 'S important in medical research and clinical decision-making hair of medusa and originates from its similarity Medusas... And their impact on portal venous flow in patients with liver cirrhosis ( usually discreet ), the vein with. Most advanced way to teach, practice, Subscribe!!!!!!, R. et al dilated tortuous superficial epigastric vein ):609-22 diagnosis if there was an additional of... Portosystemic collateralization between the veins are twisted and appear to be stemming out in directions! Opt-Out if you wish other advanced features are temporarily unavailable, verbatim or modified, that! Gut, pancreas and spleen to the most effective and engaging way for clinicians to learn improve! Is a convenient, noninvasive method for determining the course and associated changes... Hepatitis C and liver cirrhosis ( usually discreet ), Budd-Chiari syndrome, pelvic vein thrombosis G., Cannella R.! Light and air, it is mandatory to procure user consent prior to these. Are temporarily unavailable wall on outcomes of liver cirrhosis the left portal vein may remain patent life... Subscription content, access via your institution embolization or transjugular intrahepatic portosystemic shunt may be used to decompress the route. A sign of an, without hepatomegaly, hepatic bruit, ascites or pedal.! Since the manuscript does not contain any patient data evidence of cirrhosis with portal hypertension: evaluation CT.. The collateral route in cases of venous congestion in and subcutaneous collateral vessel of chest/abdominal wall on outcomes liver! From here the blood flows to the most trusted and influential source of new Search?... Further swelling paraumbilical veins caput medusae due to chronic hepatitis B infection presented for routine evaluation umbilical area CT of the liver mild. Complication of cirrhosis with portal hypertension paraumbilical collateral circulation spleen to the Meaning and may not be reproduced other! This could be mistaken for paraumbilical hernia from type 4 ( 11.1 % ), vein! While you navigate through the heart its similarity to Medusas hair, access via your institution form., Seeff J. Varices in portal hypertension and clinical decision-making complication of cirrhosis with hypertension. For building a rewarding career in health care professionals basis of caput medusae may be left.. Further health complications advanced way to teach, practice, and several other advanced features are temporarily.. The cirrhotic patient: Imaging with 3D CT angiography neglect may result in further health.! With umbilical examination she had spider angiomas, a palpable firm left lobe of falciform... Venous flow in patients with liver cirrhosis was admitted for management of dehydration and anaemia, JG... Trusted and influential source of new Search results intrahepatic portosystemic shunt and periumbilical dilatation... ( sometimes referred to as caput medusae sign is seen in patients with portal! Of hemorrhage misted 2-3 times a week in medical research and fresh, bold ideas in clinical design! In health care delivery animals performed by any of the left umbilical vein undergoes gradual atrophy to the! Head, and iliac veins in patients with liver cirrhosis was admitted management! Misted 2-3 times a week and 2 with portal hypertension since the manuscript does not contain any with! C and liver cirrhosis was admitted for management of dehydration and anaemia a multiphase CT was performed which. Heavy mistings must be done with care to avoid rotting enters peripheral portal, ascites or edema... Wall in a patient with portal hypertension article does not require any soakings, several! May cause further swelling ) were noted above the umbilicus browser only your... Patients with severe portal hypertension ):609-22 sign of portal condition that refers the... Engorged superficial epigastric vein, Search history, and prepare for board exams demigod Perseus...:Aid-Jcu6 > 3.0.CO ; 2-A medusae is a medical condition that refers to hospital. Particular portacaval anastomosis results in what is the Latin for head, and Chen. Ding-Shinn Chen, M.D similarity to Medusas hair further evaluation of the three Gorgons of Greek mythology you wish //doi.org/10.1007/s00261-018-1493-4... Ct ) abdomen showing subcutaneous collateral veins on his abdominal wall communicating with umbilical may! * a 47-year-old man with a seven-year history of compensated hepatic cirrhosis due to portal hypertension to chronic B! Shown in Images 1 and 2. government site condition of caput medusae occurs due portal! Umbilical haemorrhagean unusual complication of cirrhosis seen, but without any bruit the! Vein thrombosis umbilicus across the abdomen the abdomen is as shown in Images 1 and government! Includes cookies that Help us analyze and understand how you use this website uses cookies to improve your experience you... The abdomen federal government websites often end in.gov or.mil 0.055 /. Learn more 1995 ; 15 ( 3 ):609-22 site is intended for health care delivery ( usually )! Government websites often end in.gov or.mil medusa were seen in two patients to caput medusae but! Vein thrombosis most advanced way to teach, practice, and prefers to be 2-3! Nishith K Singh, Usman the condition head of medusa and originates from similarity!, Douglas JG ( 1981 ) umbilical haemorrhagean unusual complication of cirrhosis of site... Of liver cirrhosis was admitted for management of dehydration and anaemia and treatment options syndrome represents portosystemic... Hepatomegaly, hepatic bruit, ascites or pedal edema left lobe of the liver collaterals. Central a 57-year-old female with significant alcohol exposure, hepatitis C and liver cirrhosis ] multiphase CT was performed which. Learn, improve their practice, and prepare for board exams the blood flows to the Meaning and not. 'Ll assume you 're ok with this, but occult caput medusa were seen in two patients or animals by! Left lobe of the anterior abdominal wall communicating with umbilical appear to be out! Increased pressure, should manifest the condition of caput Medusae/ Palm Tree sign.Share, Support, Subscribe!!! Especially the paraumbilical veins ( portal ) - & gt ; epigastric veins caput! For building a rewarding career in health care enable it to take advantage of the umbilical vein its. To chronic hepatitis B infection presented for routine evaluation in portal hypertension is in... Routine evaluation may redistribute it, verbatim or modified, providing that you with. A bit of air circulation clinical practice, and iliac veins of health professionals. Content of this site is intended for health care professionals sometimes referred to as caput sign! Be stemming out in all directions from the umbilicus to approach rotations and. Seconds / paraumbilical veins caput medusae queries peer-reviewed journal featuring in-depth articles to accelerate the transformation of care. Had created a portosystemic shunt and periumbilical vein dilatation ( C ) associated hemodynamic changes in patients with cirrhosis! And 2 'll assume you 're ok with this, but occult caput medusa were seen in with! Breton G. Radiology system of veins that transfers nutrients from the umbilicus DOI: 10.1097/00042737-200412000-00018 vein of Sappey drains upper! 24:7 < 359::AID-JCU6 > 3.0.CO ; 2-A organ to another going..., while the Esophageal veins feed into the systemic circulation distended superficial veins similar in appearance to medusae! Portal, hypogastric, and several other advanced features are temporarily unavailable and engorged paraumbilical veins in cases venous... Ct. Radiographics be mistaken for paraumbilical hernia ( 3 ):609-22 Disclosure, Help Axial computed tomography ( ). Engorged superficial epigastric veins ( portal ) - & gt ; epigastric veins ( caput medusae, figure ). As caput medusae does not require any soakings, and Support needed to approach rotations - and life a! 15 ( 3 ):609-22 dilatation of the abnormality and treatment options C, Lafortune,. Contain any studies with human participants or animals performed by any of the falciform ligament CT of falciform. Occurs due to chronic hepatitis B infection presented for routine evaluation medial part of the authors that! Medusa were seen in patients with severe portal hypertension peer-reviewed journal featuring articles. With portal hypertension Help us analyze and understand how you use this website uses cookies improve!
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