Dilated Abdominal Veins

CLINICAL DIAGNOSTIC MANUAL

Dilated abdominal veins, also known as abdominal collateral circulation, are a clinical sign indicating significant venous obstruction, either at the level of the portal vein or the vena cavae.

This phenomenon occurs when blood seeks alternative routes to return to the heart due to the obstruction of normal venous flow. The causes of this condition can vary, and identifying them is crucial for the proper management of the patient.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Portal hypertension	Dilated veins on the abdomen (caput medusae), ascites, splenomegaly, jaundice, varices, haemorrhage	Medical history, physical examination, signs of cirrhosis	Doppler ultrasound, contrast-enhanced CT, liver biopsy
Superior vena cava obstruction	Facial and arm oedema, cyanosis, distended neck and upper chest veins, respiratory difficulty, cough, dysphagia	Medical history, physical examination	Contrast-enhanced CT, MRI, angiography
Inferior vena cava obstruction	Lower limb oedema, abdominal venous distension, ascites, hepatomegaly, renal insufficiency	Medical history, physical examination	Doppler ultrasound, contrast-enhanced CT, MRI, angiography