Superficial collateral veins on abdominal CT: findings in cirrhosis and systemic venous obstruction

Inspection of the superficial veins of the abdominal wall has long been a routine part of the physical examination. To date, radiologists have given such veins rather scant attention, even though they are elegantly demonstrated by CT. We have performed a study of 21 patients with cirrhosis, 7 patients with caval obstruction and 28 normal control counterparts in order to determine whether superficial veins were more numerous in these two clinical conditions. The 7 patients with caval obstruction included 4 with superior and 3 with inferior vena cava obstructions. Electronic data from the CT examinations of these 28 cases and 28 controls were analysed on a viewing console. Superficial veins were significantly more numerous in patients with cirrhosis (mean maximum=5, p<0.01) and caval obstruction (mean maximum=9.1, p<0.01) than in the normal controls (mean maximum=2.1). The combination of too many superficial veins and a large superior mesenteric vein is a pointer towards cirrhosis. The presence of excessive superficial veins is yet another clue to the presence of underlying disease when analysing abdominal CT.