meaning no caput medusae, dilated/engorged/varicose (superficial/anterior) abdominal wall veins or other venous stigmata seen/inspected/coursing over the abdominal wall...

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Note added at 1 ώρα (2009-10-22 14:38:10 GMT)
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con reticoli venosi non esclusivamente i caput medusae vengono intesi...

"...RETICOLI VENOSI (identificazione direzione corrente)

- circoli cavo-cavali

- circoli porto-cavali (“caput medusae”)..."

http://medicina.unipr.it/didattica/att/2786.file.ppt.
medicina.unipr.it/didattica/att/2786.file.ppt

"...presenza di reticoli venosi. Ne esistono due grandi famiglie:

porto-cavali: in sede periombelicale con flusso ombelifugo sono dovuti a ipertensione portale;

cavo-cavali: in sede periferica e con flusso dal basso verso l’alto sono dovuti a ostruzione della cava inferiore sottoepatica;..."
http://www.scholamedica.it/index.php?option=com_docman&task=...
www.scholamedica.it/index.php?option=com...task...

Visible veins Abnormally prominent veins on the abdominal wall suggest portal ... produces distended veins which drain away from the umbilicus: the 'caput ...
http://books.google.gr/books?id=-WMArUmBsEgC&lpg=PT213&ots=A...

Distended veins, "including" caput medusa - Stomas- abnormal opening of bowel lumen to anterior abdominal wall, created by surgeons to allow lumen contents to ...
osceweb.co.uk/index.php?...
http://osceweb.co.uk/index.php?option=com_content&task=view&...

"...3) Abdominal veins
The presence of distended abdominal veins indicates impairment of circulation caused by portal hypertension or obstruction of superior or inferior vena cava. Prominence of these vessels, called abdominal wall varicosis, indicates increased collateral circulation as a result of obstruction in the portal venous system or in the vena cava. With obvious portal hypertension, the dilated veins appear to radiate outward from the umbilicus, like the head of medusa, so these distended veins are called caput medusae.


If a vein is engorged, the direction of flow can be demonstrated by a simple maneuver, that is, placing the index fingers side by side over the vein, pressing laterally, separating the fingers one by one, and observing the time it takes the veins to refill from each direction; the flow of venous blood is in the direction that fills the fastest.

In portal hypertension normal flow direction is maintained. In contrast, obstruction of the vena cava alters the flow direction in these veins.

In obstruction of the superior vena cava, the flow direction in the upper abdominal venous collaterals is reversed or downward.

In inferior vena cava obstruction the direction is reversed in the lower abdominal veins, and they will drain upward..."
http://jpkc.shsmu.edu.cn/diagnostics/jiaoan/22.doc.
jpkc.shsmu.edu.cn/diagnostics/jiaoan/22.doc






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Note added at 1 ώρα (2009-10-22 14:45:46 GMT)
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reticoli venosi superficiali (in corso di ipertensione portale) e laterali (con ostruzione della cava superiore)...
http://books.google.gr/books?id=R92FI-7i4JAC&lpg=RA10-PT647&...