devil’s mask sign

devil’s mask sign

A term referring to an ultrasonographic finding in an alcoholic who was admitted to hospital while celebrating Martedì Grasso in Carnevale di Venezia. The drinker consumed 2 litres of red wine/day X 15+ years, and had an admission blood alcohol concentration of 150 mg/dl (33 mmol/l); he had mildly tortuous veins on the abdominal wall, especially above the umbilicus (caput medusae), and was still wearing a carnival devil’s mask.

Imaging
Abdominal ultrasonography revealed cirrhosis, a recanalised umbilical vein and patent hepatic veins.

Colour
Doppler ultrasonography confirmed portal hypertension with subcutaneous collateral veins on the anterior abdominal wall near the umbilicus that arose from the dilated paraumbilical veins, which strikingly resembled the devil’s mask he was wearing.