Presentation
Abdominal pain and elevated liver enzymes.
Patient Data
The liver has relatively irregular margin in keeping with cirrhosis. No hepatic mass is identified in current study.
Multiple dilated collateral vessels are seen particularly at splenorenal regions. Additionally, fat containing umbilical hernia is present accompanied by recanalization of umbilical vein causing caput medusae sign.
Three hyperdense stones are seen in gallbladder.
The spleen is enlarged and its cephalocaudal height measured 180 mm.
The right kidney is markedly small and shows severe parenchymal atrophic changes.
The prostate gland is enlarged.
A little amount abdominopelvic free fluid is observed.
Case Discussion
Cirrhosis with evidence of portal hypertension, Caput medusae sign, splenomegaly & mild ascites.
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.