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Related Experiment Video

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Caput Medusae Mimicking Umbilical Hernia.

Rahul Kumar1, Tanvi Batra2, Atul Kakar3

  • 1DNB Trainee, Department of Internal Medicine, Sir Ganga Ram Hospital, New Delhi, India, Orcid: https://orcid.org/0009-0005-5247-0113, Corresponding Author.

The Journal of the Association of Physicians of India
|September 16, 2025
PubMed
Summary
This summary is machine-generated.

A woman with chronic liver disease developed jaundice, abdominal swelling, and leg edema. She also had a growing umbilical swelling with a palpable thrill and Cruveilhier-Baumgarten murmur, indicating portal hypertension complications.

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Area of Science:

  • Hepatology
  • Vascular Surgery
  • Internal Medicine

Background:

  • Chronic liver disease (CLD) can lead to serious complications.
  • Portal hypertension is a common complication of CLD, causing significant morbidity.
  • Umbilical hernias can occur, but a specific type associated with a murmur is rare.

Purpose of the Study:

  • To describe a rare case of a large umbilical hernia with Cruveilhier-Baumgarten murmur in a patient with CLD.
  • To highlight the diagnostic significance of physical examination findings in CLD complications.
  • To discuss the management implications of such a presentation.

Main Methods:

  • Case report of a 34-year-old female with diagnosed CLD.
  • Clinical presentation including jaundice, ascites, pedal edema, and umbilical swelling.
  • Physical examination findings: palpable thrill and audible Cruveilhier-Baumgarten murmur over the umbilical swelling.

Main Results:

  • The patient presented with signs of decompensated CLD and a large, non-reducible umbilical swelling.
  • The umbilical swelling exhibited a palpable thrill and an audible Cruveilhier-Baumgarten murmur.
  • These findings are indicative of a recanalized umbilical vein due to portal hypertension.

Conclusions:

  • The Cruveilhier-Baumgarten murmur in the context of CLD and umbilical swelling strongly suggests a recanalized umbilical vein.
  • This physical sign is a critical indicator of severe portal hypertension.
  • Early recognition and management are essential for patients with CLD presenting with such findings.