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
Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
for "head of Medusa") originates from the apparent similarity to
Medusa
In Greek mythology, Medusa (; ), also called Gorgo () or the Gorgon, was one of the three Gorgons. Medusa is generally described as a woman with living snakes in place of hair; her appearance was so hideous that anyone who looked upon her wa ...
'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 formation of scar tissue (fibrosis) in the liver. The appearance is due to cutaneous 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
The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the ...
and permit venous return from the
leg
A leg is a weight-bearing and locomotive anatomical structure, usually having a columnar shape. During locomotion, legs function as "extensible struts". The combination of movements at all joints can be modeled as a single, linear element cap ...
s.
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
See also
*
Portacaval anastomosis
In ''
Liver Cirrhosis
Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a chronic condition of the liver in which the normal functioning tissue, or parenchyma, is replaced ...
'', the paraumbilical veins open up to transfer portal venous blood into systemic circulation. It results in caput medusae.
References
External links
{{Vascular diseases
Medical signs
Diseases of veins, lymphatic vessels and lymph nodes