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Caput medusae

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

For the cactus see Astrophytum caput-medusae

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.

It is caused by the umbilical vein which carries oxygenated blood from mother to fetus in utero and normally closes within one week of birth can becoming re-canalised due to portal hypertension caused by liver failure.

Differential diagnosis

Inferior vena cava obstruction

How to differentiate

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 .

See also