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. Most drugs like beta-blockers, derivatives of vasopressin and somatostatins work by inducing splanchnic vasoconstriction and decrease the portal venous pressure. The patient was prepared to undergo surgical shunting procedure.Īcute variceal bleeding is a medical emergency, and patients need aggressive form of treatment. He was on regular anticoagulants and beta blockers. Tillandsia caput medusae is sometimes called Medusas Head Air Plant because of its bulbous base and swirling leaves. Caput medusae sign is frequently mentioned in medical books as a sign of portal hypertension but such hugely dilated veins are very rarely seen in clinical. The past medical history was negative apart from idiopathic portal vein thrombosis. Endoscopy showed variceal bleeding which was mild, multiple bandings were performed for the bleeding vessels. The patient received two units of blood and four units of fresh frozen plasma, intravenous propranolol and intravenous vasopressin. The hemoglobin level was low and liver enzymes were mildly elevated. Abdominal examination showed hugely dilated veins in the abdominal wall with palpable spleen and liver. He was admitted to the emergency department. Seeking superior fine art prints of Perseus and Caput Medusa, Plate 6, View of the Heavens by Sidney Hall Customize the size, media & framing for your. Medusa-head is a non-native grass that is considered a noxious weed in several western states, where it has invaded vast areas formerly dominated by native. 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.Ī 53-year-old male presented to the emergency department complaining from hematemesis.
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