Caput medusae

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Caput medusae
Classification and external resources
Caput medusae CT ax 002.jpg
Axial CT showing portosystemic collateral circulation via the umbilical vein: caput medusae in liver cirrhosis
ICD-10 I86.8 (ILDS I86.820)
ICD-9 456.8

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 umbilical vein carries oxygenated blood from mother to fetus in utero, and normally closes within one week of birth. In portal hypertension, the umbilical vein can become re-canalized.

Differential diagnosis[edit]

Inferior vena cava obstruction[edit]

How to differentiate[edit]

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

  • Caput Medusae - flow is towards the legs
  • Inferior vena cava obstruction - flow is towards the head.

See also[edit]

References[edit]