© Borgis - New Medicine 1/2014, s. 24-25
*Konrad Wroński1, 2
Caput medusae in alcoholic liver disease – case report
1Faculty of Medicine, Department of Oncology, University of Warmia and Mazury, Olsztyn, Poland
Head of Department: prof. Sergiusz Nawrocki, MD, PhD
2Department of Surgical Oncology, Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre, Olsztyn, Poland
Head of Department: Andrzej Lachowski, MD
Caput medusae is the symptom of portal hypertension due to cirrhosis of liver. This symptom is encountered in medical practice less and less due to earlier diagnostic and effective treatment of portal hypertension. In this article the author present a case of a man who reported to the hospital because of huge ascites due to cirrhosis of liver. After draining ascitic fluid the symptom of caput medusae was observed.
Caput medusae is the symptom of portal hypertension due to cirrhosis of liver (1-3). This symptom is encountered in medical practice less and less due to earlier diagnostic and effective treatment of portal hypertension (1, 4, 5).
A 53-year-old man, Caucasian race, was admitted to the hospital because of the huge ascites and general destruction. He had history of alcohol consumption about 80-120 gram/day for 20 years and he was heavy smoker – 20 cigarette/day for 20 years. The patient had suffered from cirrhosis of the liver for 5 years. Serology for viral hepatitis B and C were negative. During palpable examination, drew attention to the huge ascites (fig. 1). A umbilical revealed the presence of varicose veins (fig. 2). After drainage 2 liters of ascetic fluid were seen superficial epigastric veins radiating from a umbilical large venous varix (fig. 3).
Fig. 1. Dilated superficial epigastric veins radiating from a umbilical large venous varix.
Fig. 2. Umbilical large venous varix.
Fig. 3. Dilated superficial epigastric veins and bruising caused by thrombocytopenia.
The patient serum total bilirubin was 4.0 mg/dL, platelets – 11.000/mm3, white blood cells – 4.300/mm3, gamma glutamyltranspeptidase – 735 U/L, asparate aminotransferase – 40 U/L, alanine amnotranserase – 18 U/L.
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zaakceptowano do druku: 2014-02-19
Adres do korespondencji:
General Surgery Consultant Faculty of Medicine, Department of Surgical Oncology University of Warmia and Mazury, Olsztyn, Poland
37 al. Wojska Polskiego, 10-228 Olsztyn
tel.: +48 505-818-126
e-mail: email@example.comNew Medicine 1/2014
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