Caput Medusae

What is Caput Medusae?

Caput Medusae is a medical condition that refers to the appearance of swollen veins on the abdomen. The veins are twisted and appear to be stemming out in all directions from the umbilicus (commonly known as the belly button). Similar swelling can occur in other parts of the body such as around the rectum, the meeting point of the esophagus and the stomach. The veins swell or the fluids, water or blood in them may cause further swelling. The inflamed veins are called paraumbilical veins.

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Why does it happen?

The condition of Caput Medusae occurs due to portal hypertension. Portal circulation is the flow of blood from one organ to another without going through the heart. It is a unique system of veins that transfers nutrients from the gut, pancreas and spleen to the liver. During portal circulation, the pressure is extremely high. In case of an increased flow of blood or an obstruction, the pressure within the system also rises simultaneously. When proper blood flow is difficult, the body attempts at opening an alternative arrangement of veins by a build-up of pressure, thus resulting in the swelling of the veins that appear on the abdomen.

Symptoms of Caput Medusae

• Swelling of the legs and belly due to fluid build-up in the body
• Belly button sticks out
• Enlarged spleen
• Humming sound of the blood passing and the sound becomes louder while breathing

Causes of Caput Medusae

• Liver Cirrhosis: Cirrhosis is a condition of chronic liver damage that results in scarring and eventually liver failure. The disease occurs mostly due to excessive alcohol consumption on a regular basis. The condition that cannot heal completely, therefore, its effects are long-lasting. Such a state of the liver may cause trouble in the flow of blood to it, resulting in caput medusa.
• Hepatitis B and C: These health problems are a result of infection by the hepatitis B and hepatitis C virus. The disease is characterized by the urine becoming dark and yellowing of eyes. In severe cases, it can cause scarring and liver failure. Although the condition needs some time to regain health, certain cases may require a liver transplant.
• Autoimmune hepatitis: The primary function of the immune system is to protect the body from diseases by killing any foreign bodies entering the body. Autoimmune hepatitis is a condition in which the immune system attacks the liver due to a functional error. The symptoms include joint pain, fatigue and abdominal discomfort. It is also another cause of caput medusa.
• Nonalcoholic steatohepatitis: Build up of fat in the liver is the main feature of nonalcoholic steatohepatitis. The condition results in liver inflammation and damage. Although there are no symptoms of this health problem, it damages the cells of the liver. In this situation, the liver is unable to carry out its functions normally.
• Heart failure: The heart is responsible for pumping blood to the entire body. Maintaining healthy levels of blood in the body is an essential function of the heart. If the heart does not work correctly, it will affect the flow of blood within the system. Disruption of the normal blood circulation will cause portal hypertension eventually leading to caput medusae.

Diagnosis For Caput Medusae

• Physical examination
• Thorough checking of the individual’s medical background
• CT scan
• Color Doppler ultrasonography
• Blood test

Treatments For Caput Medusae

There is no particular treatment for caput medusae. However, treatment can be given by the causes of the condition.

• Liver Cirrhosis: Limit alcohol consumption and take no prescriptions medicines like naproxen, acetaminophen, aspirin, ibuprofen, etc. Individuals should also consider getting immunized against hepatitis B, pneumococcus, influenza, etc. Low sodium content in the diet will help to avoid accumulation of fluid in the chest and belly.
• Hepatitis: Cases of hepatitis heal itself within a few weeks or months. However, antiviral drugs such as lamivudine pegylated interferon, ribavirin, etc. may be prescribed. However, in some cases, a liver transplant may be needed if the liver is beyond repair.
• Nonalcoholic steatohepatitis: The condition occurs due to fatty liver and to treat this issue, people must indulge in regular exercise. Weight loss helps in speedy recovery from the disease. Medications like anti-oxidants, insulin sensitizers, lipid-lowering drugs, omega 3 fatty acids or ursodeoxycholic acid can be given to improving the health of the individual.
• Autoimmune hepatitis: The goal of the treatment for autoimmune hepatitis should be to stop or slow the attack on the liver. Medications such as azathioprine, prednisone, etc. that lower the immune system activity is often prescribed. People are usually advised to continue taking the medication for about 12-24 months before they get into remission.
• Heart failure: To treat heart failure doctors may repair a damaged heart valve or control fast heart rhythms. Angiotensin-converting enzymes inhibitors, beta blockers, angiotensin II receptor blockers, diuretics, inotropes, aldosterone antagonists and digoxin are some of the medications that can help to treat heart failures. Doctors can also advise patients to undergo surgeries like heart valve repair or replacement, coronary bypass surgery, cardiac resynchronization therapy, or the use of devices like implantable cardioverter defibrillators and heart pumps. Cases that are beyond repair need a heart transplant.

When to visit a Doctor?

The appearance of swollen veins in the abdominal area is not a common occurrence. Treating such a situation with neglect may result in further health complications. Therefore, people must consult a doctor as soon as such developments are visible on their body.