Caput medusae

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Caput medusae
Classification and external resources
ICD-10	I 86.8 (ILDS I86.820)
ICD-9	456.8

Caput medusae 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 hair once Minerva had turned it into snakes^{[citation needed]}.

1 Causes
2 Differential diagnosis
- 2.1 Inferior vena cava obstruction
  - 2.1.1 How to differentiate
3 See also
4 References

Causes

It is a sign of severe portal hypertension that has decompressed by portal-systemic shunting through the paraumbilical veins.^[1]

Differential diagnosis

Inferior vena cava obstruction

Produces abdominal collateral veins to bypass the high pressure portal system and permit venous return from the legs.

How to differentiate

Determine the direction of flow in the veins below the umbilicus.

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

References

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Cardiovascular disease: vascular disease · Circulatory system pathology (I70–I99, 440–456)

Arteries, arterioles
and capillaries

Inflammation

Arteritis (Aortitis) · Buerger's disease

Arterial occlusive disease/
peripheral vascular disease

Arteriosclerosis	Atherosclerosis (Foam cell, Fatty streak, Atheroma, Intermittent claudication) · Monckeberg's arteriosclerosis · Arteriolosclerosis (Hyaline, Hyperplastic, oxycholesterol, cholesterol, LDL, trans fat)
Stenosis	Renal artery stenosis · Carotid artery stenosis
Other	Fibromuscular dysplasia · Degos disease · Aortoiliac occlusive disease · Raynaud's phenomenon/Raynaud's disease · Erythromelalgia

Aneurysm/dissection/
pseudoaneurysm

torso: Aortic aneurysm (Thoracic aortic aneurysm, Abdominal aortic aneurysm) · Aortic dissection · Coronary artery aneurysm
head/neck: Cerebral aneurysm · Intracranial berry aneurysm · Carotid artery dissection · Vertebral artery dissection · Familial aortic dissection

Vascular malformation

Arteriovenous malformation · Arteriovenous fistula · Telangiectasia (Hereditary hemorrhagic telangiectasia)

Vascular nevus

Spider angioma · Halo nevus · Cherry hemangioma

Veins

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

Arteries or veins

Vasculitis · Thrombosis · Embolism (Pulmonary embolism, Cholesterol embolism, Paradoxical embolism) · Angiopathy (Macroangiopathy, Microangiopathy)

Blood pressure

Hypertension	Hypertensive heart disease · Hypertensive nephropathy · Essential hypertension · Secondary hypertension (Renovascular hypertension) · Pulmonary hypertension · Malignant hypertension · Benign hypertension · Systolic hypertension · White coat hypertension
Hypotension	Orthostatic hypotension