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Figure 1 Image of the Week #2

Michael Macias

What is the name of this clinical finding and what does it suggest?





Image of the Week -  Caput Medusae 

Caput Medusae is the term used to describe these tortuous veins when they become prominent on the surface of the abdomen. It is classically associated with portal hypertension and cirrhosis. 

The differential for this particular case also includes Inferior Vena Cava Obstruction (IVCO). To distinguish between Caput Medusae or IVCO, occlusion of the vein is required. If it flows towards the legs, it is Caput Medusae. If it flows towards the head, it is IVCO. 


How to determine blood flow in a vein


This is a stark finding and the diagnosis of cirrhosis or portal hypertension is usually not this obvious. To exclude cirrhosis, combinations of normal laboratory findings are most useful. Check out the JAMA article below that looks at clinical indicators that are useful in identifying cirrhosis in adults with suspected liver disease. 

 Original Article

Original Article

To see more cases like this, visit Figure 1. I encourage you to check it out and continue to work on your visual diagnosis skills!