diagnose this?

Diagnosis : Caput medusae

Caput medusae is the appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to joinsystemic veins. The name caput medusae (Latin for "head of Medusa") originates from the apparent similarity to Medusa's hair once Venus had turned it into snakes.

Differential diagnosis

Inferior vena cava obstruction

• Cirrhosis cause portal hypertension.
• Produces abdominal collateral veins to bypass the high pressure portal system and permit venous return from the legs.

How to differentiate

Determine the direction of flow in the veins below the umbilicus. After pushing down on the prominent vein, blood will:

• Caput Medusae - flow is towards the legs
• Inferior vena cava obstruction - flow is towards the head.