Dataset Information

Caput medusae sign; a unique finding during abdominal examination in patients with portal hypertension; case report.

ABSTRACT: Portal hypertension is an increase in the portal venous pressure resulting in the formation of dilated veins at the site of porto-systemic venous anastomosis causing shifting of the blood flow from the portal venous system to the systemic circulation. A 53-year-old male presented to the emergency department complaining from hematemesis. He was admitted to the emergency department. Abdominal examination showed hugely dilated veins in the abdominal wall with palpable spleen and liver. The hemoglobin level was low and liver enzymes were mildly elevated. The patient received two units of blood and four units of fresh frozen plasma, intravenous propranolol and intravenous vasopressin. Endoscopy showed variceal bleeding which was mild, multiple bandings were performed for the bleeding vessels. The past medical history was negative apart from idiopathic portal vein thrombosis. He was on regular anticoagulants and beta blockers. The patient was prepared to undergo surgical shunting procedure. Acute variceal bleeding is a medical emergency, and patients need aggressive form of treatment. Most drugs like beta-blockers, derivatives of vasopressin and somatostatins work by inducing splanchnic vasoconstriction and decrease the portal venous pressure. Endoscopic band ligation may be required but this has no effect on the portal venous pressure, other alternatives include trans-jugular intrahepatic portosystemic shunts or surgery.

SUBMITTER: Mohammed AA

PROVIDER: S-EPMC7191313 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Caput medusae sign; a unique finding during abdominal examination in patients with portal hypertension; case report.

Mohammed Ayad Ahmad AA

Annals of medicine and surgery (2012) 20200424

Portal hypertension is an increase in the portal venous pressure resulting in the formation of dilated veins at the site of porto-systemic venous anastomosis causing shifting of the blood flow from the portal venous system to the systemic circulation. A 53-year-old male presented to the emergency department complaining from hematemesis. He was admitted to the emergency department. Abdominal examination showed hugely dilated veins in the abdominal wall with palpable spleen and liver. The hemoglob ...[more]

PMID: 32373342

Similar Datasets

Project description:Introduction Portal hypertension is a rare complication of liver metastases. The study highlights that clinician should be aware of conditions mimicking cirrhosis with similar clinical presentation and imaging findings. Case presentation We present the case of a 29-year-old non-alcoholic lady who presented to our hospital with a history of two months of progressive, painless abdominal distension and progressively increasing yellowish discoloration of the eyes. Physical examination, laboratory investigations, and imaging tests led to a diagnosis of multiple metastases from breast carcinoma to the liver leading to portal hypertension after exclusion of other causes of portal hypertension. However, after three weeks of presentation to the hospital, the patient died before any therapeutic measures were initiated to address breast carcinoma. Clinical discussion Liver metastasis from primary breast carcinoma rarely presents with clinical symptoms of portal hypertension. Although portal hypertension secondary to pseudocirrhosis, predominantly linked to ongoing chemotherapy for known cancers, has been previously described in case studies, our case had an unusual presentation leading to diagnostic uncertainty. Conclusion Our case highlights the rare cause of liver metastasis secondary to breast carcinoma, which presented as portal hypertension. Highlights • Portal hypertension is a rare complication of liver metastases, frequently occurring in malignant diseases.• In patients with liver metastases, chemotherapy can result in areas of retracted tumor tissue and scarring, also known as pseudocirrhosis.• Although portal hypertension is secondary to pseudocirrhosis and predominantly linked to ongoing chemotherapy for known cancers, our case had an unusual presentation leading to diagnostic uncertainty.• The patient has an atypical presentation with symptoms consistent with portal hypertension and chronic liver disease without prior exposure to chemotherapy which could be due to the tumor deposits resulting in sinusoidal obstruction, subsequently leading to portal hypertension.

Dataset Information

Caput medusae sign; a unique finding during abdominal examination in patients with portal hypertension; case report.

Publications

Caput medusae sign; a unique finding during abdominal examination in patients with portal hypertension; case report.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets