Caput medusae

Caput Medusae is a medical condition characterized by the appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. The condition is named after Medusa, a gorgon in Greek mythology who had snakes in place of hair. The appearance of the veins is said to resemble the snakes on Medusa's head.

Causes

The primary cause of caput medusae is portal hypertension, a condition characterized by increased pressure in the portal venous system. This can occur due to various conditions such as cirrhosis of the liver, hepatic vein thrombosis, and schistosomiasis. The increased pressure in the portal vein causes the blood to be redirected to smaller veins, leading to their dilation and the characteristic appearance of caput medusae.

Symptoms

The most noticeable symptom of caput medusae is the visible distention of veins around the navel. Other symptoms may include jaundice, ascites, and hepatic encephalopathy. These symptoms are often associated with the underlying cause of the portal hypertension.

Diagnosis

Diagnosis of caput medusae is primarily based on physical examination. The presence of distended veins around the navel in a patient with known liver disease is highly suggestive of the condition. Additional tests may be performed to confirm the diagnosis and determine the severity of the portal hypertension. These may include liver function tests, ultrasound of the abdomen, and endoscopy to check for esophageal varices.

Treatment

Treatment of caput medusae is aimed at managing the underlying cause of the portal hypertension. This may involve medication to reduce the pressure in the portal vein, procedures to divert the blood flow away from the liver, or liver transplantation in severe cases.

Prognosis

The prognosis of caput medusae depends on the severity of the underlying liver disease. With appropriate treatment, the symptoms of caput medusae can be managed effectively. However, the condition is often associated with advanced liver disease, which can have a poor prognosis.

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