Caput medusae
Other names	Palm tree sign
Axial CT showing portosystemic collateral circulation via the umbilical vein: caput medusae inliver cirrhosis
Specialty	Gastroenterology

Caput medusae is the appearance of distended and engorgedsuperficial epigastric veins, which are seen radiating from theumbilicus across the abdomen. The namecaput medusae (Latin for "head of Medusa") originates from the apparent similarity toMedusa's head, which had venomous snakes in place of hair. It is also a sign ofportal hypertension.^[1] 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.^[2] It is caused by dilation of theparaumbilical veins, which carry oxygenated blood from mother to fetusin 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.^[3]

• Producesabdominalcollateral veins to bypass the blockedinferior vena cava and permit venous return from thelegs.

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^[4]

• Portacaval anastomosis

InLiver Cirrhosis, the paraumbilical veins open up to transfer portal venous blood into systemic circulation. It results in caput medusae.^[5]

• Medical signs
• Diseases of veins, lymphatic vessels and lymph nodes

• Articles with short description
• Short description matches Wikidata
• Short description is different from Wikidata