Caput medusa

Discussion:

Caput medusa (head of Medusa with multiple serpent-like veins in the umbilicus) reflects portal hypertension with the umbilicus being the end point for the recanalized paraumbilical vein (in this case highlighted by the fat-containing umbilical hernia).  These veins are at higher pressure than normal thus are prone to hemorrhage with minimal trauma.  Indeed in some cases, this can be fatal due to the associated coagulopathy of chronic liver disease.

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