VizD Challenge Week of 1/28/08
A 53-year-old woman presents to your ED with ankle pain. She has a long history of ethanol use. During your complete physical exam, you notice the finding seen in the image below.
(click on image to enlarge)
Questions:
1. What is the diagnosis?
2. What is the etiology of this condition?
Winner receives $5!
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VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.
7 comments:
-Caput Medusae
-Enlargement of the paraumbilical veins due to portal hypertension secondary to alcoholic cirrohsis of the liver. Blood returns from the common hepatic vein, through the paraumbilical veins to the external iliac through the inferior epigastric veins, and to the brachiocephalic and subclavian veins through the superior epigastric veins.
caput medusae secondary to portal hypertension which in turn likely caused by alcoholic liver damage.
Abdominal Hernia?
Epigastric Varices?
1. Caput Medusae
2. Portal Hypertension
a. Caput medusa b. venous portal hypertension due to cirrhosis
These are abdominal wall varicies. Due to liver disease and subsequent portal hypertension. I bet she has esophageal, gastric, and rectal (haemorrhoids) varicies too.
1. Esophageal varices
2. Etiology, especially for "uphill" varices, is hepatic damage resulting from excess ETOH consumption, usually cirrhosis but sometimes acute hepatitis.
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