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Chronic Liver Disease
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Julia M. Boster, Kelly A. Klaczkiewicz, Shikha S. Sundaram
Infants and children with cholestasis may have acholic stools, which are pale or clay-colored due to the lack of normal bile in the stool. Patients with cirrhosis can develop clinical signs and symptoms of portal hypertension, including ascites and a caput medusa. Esophageal or gastric varices may present with obvious hematemesis (vomiting blood) or melena (stool that is dark/black and tarry from digested blood), but the bleeding may be occult. Gastrointestinal bleeding in patients with cirrhosis is a medical emergency and can be life-threatening.
The digestive system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Distention of abdominal and esophageal veins (esophageal varices) due to increased portal and venous pressures. Caput medusae is a term used to describe the distended abdominal veins that are seen in patients with alcoholic cirrhosis
Stomas
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
John R.T. Monson, Iain Andrew Hunter
Parastomal varices form as a result of portal hypertension and subsequent shunting between the veins of the intestine and the abdominal wall. They are often seen in patients with colitis and associated sclerosing cholangitis. They effect up to 5% of patients with a stoma and coexisting portal hypertension of any aetiology. Whilst some may manifest as a classic parastomal Caput medusa, most are only evidenced by recurrent bleeding.193 The diagnosis should therefore be considered in all cases of problematic stoma bleeding, and hepatology support requested as appropriate. Bleeding tends to present either as a generalised slow venous ooze from a congested stoma or as a spurting high pressure venous bleed from a single varix. As with any variceal bleeding, this does have the potential to be of a life-threatening magnitude. Initial management is by local compression and resuscitation. As with oesophageal varices, other local treatments such as direct sclerosant injection can be employed. However, whilst local measures may provide temporary relief, re-bleeding is almost inevitable (85%).
Role of developmental venous anomalies in etiopathogenesis of demyelinating diseases
Published in International Journal of Neuroscience, 2019
Siddika Halicioglu, Sule Aydin Turkoglu
Deep medullary veins and the drainage vein may be demonstrated particularly in susceptibility-weighted images (SWI) that require no contrast agent [8]. DVAs constitute centripetally emptied medullary veins, and superficial subcortical veins or subependimal veins conjoining with transcerebral veins, and this image is named as the caput medusa. Collective venous drainage may frequently be observed, particularly in enhanced images, and macroscopically DVAs are described as enlarged thin-walled medullary veins that radially and centrifugally empty the white and gray matter to a larger collecting or emptying vein that opens to superficial subcortical or deep pial veins [9,10]. Although the etiology is controversial, it has generally been accepted to develop due to focal inhibition of medullary vessel development or due to medullary vessel occlusion between the fourth or seventh stage of Padget [11]. DVAs are frequently benign and are incidentally detected; however, they may rarely be symptomatic [12].
Recognizing skin conditions in patients with cirrhosis: a narrative review
Published in Annals of Medicine, 2022
Ying Liu, Yunyu Zhao, Xu Gao, Jiashu Liu, Fanpu Ji, Yao-Chun Hsu, Zhengxiao Li, Mindie H. Nguyen
Caput medusa should be differentiated from vena cava obstruction syndrome (Figure 1(i)). In the latter, abdominal varicose veins are located on the right or bilateral abdomen [23]. The blood flow direction of the abdominal varicose veins of the superior vena cava obstruction syndrome is from top to bottom, and that of the inferior vena cava obstruction syndrome is from bottom to top [24].
Giant tumour thrombus with congestive hepatopathy: value of multimodality imaging
Published in Acta Cardiologica, 2022
Physical examination showed caput medusa and peripheral oedema. Liver tests suggested congestive hepatopathy (i.e. elevated gamma-glutamyltransferase and alkaline phosphatase). Echocardiography subcostal view revealed a mass in the right atrium bulging from the inferior vena cava (IVC) (*, Figure 1(A), Supplementary data online, video S1 and S2).