Caput medusae sign - portal hypertension

Last revised by Daniel J Bell on 26 Aug 2022

The caput medusae sign is seen in patients with severe portal hypertension. It describes the appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to join the systemic veins. 

History and etymology

Caput is the Latin for head, and the sign literally translates as head of Medusa 4.

The appearance is reminiscent of the hair of Medusa, one of the three Gorgons of Greek mythology. The Gorgons had venomous snakes for hair and their countenance was said to be so terrifying that anyone who looked upon them was literally turned to stone. Medusa was encountered and beheaded by the Greek demigod hero Perseus 2,3.

See also

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Cases and figures

  • Figure 1: clinical photograph
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  • Figure 2: Medusa
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