The thoracoepigastric vein runs along the lateral aspect of the trunk between the

superficial epigastric vein Superficial may refer to: *Superficial anatomy, is the study of the external features of the body *Superficiality, the discourses in philosophy regarding social relation * Superficial charm, the tendency to be smooth, engaging, charming, slick and ...

below and the

lateral thoracic vein The lateral thoracic vein (sometimes debatably referred to as the long thoracic vein) is a tributary of the axillary vein. It runs with the lateral thoracic artery and drains the Serratus anterior muscle and the Pectoralis major muscle. Normal ...

above and establishes an important communication between the

femoral vein In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends a ...

and

axillary vein In human anatomy, the axillary vein is a large blood vessel that conveys blood from the lateral aspect of the thorax, axilla (armpit) and upper limb toward the heart. There is one axillary vein on each side of the body. Structure Its origin ...

. This is an especially important vein when the

inferior vena cava The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of th ...

(IVC) becomes obstructed, by providing a means of collateral venous return. It creates a cavocaval anastomosis by connecting with superficial epigastric veins arising from femoral vein just below inguinal ligament.

Clinical significance

The thoracoepigastric vein is unique in that it drains to both the

Superior Vena Cava The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein th ...

(SVC) and to the

Inferior Vena Cava The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of th ...

(IVC). Hence, it serves as an anastomotic caval-caval link between the two. Furthermore, the thoracoepigastric vein is connected to the portal vein via the

paraumbilical vein In the course of the round ligament of liver, small veins (paraumbilical) are found which establish an anastomosis between the veins of the anterior abdominal wall and the hepatic portal, hypogastric, and iliac veins. The best marked of these s ...

and thereby serves as a portocaval anastomosis as well. When a patient experiences portal hypertension, there can be congestion (backup) of blood that enters into the caval system via the thoracoepigastric vein. When this occurs, there can be an externally visible dilation of the paraumbilical (and perhaps even the thoracoepigastric veins) which leads to the appearance of "Caput Medusae".

Caput Medusae Caput medusae is the appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. The name ''caput medusae'' (Latin for "head of Medusa") originates from the apparent similar ...

is a

clinical sign Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...

that is recognized by the physician by the characteristic appearance of distended veins emanating from the umbilicus of the patient. The shape of these veins and their arrangement around the umbilicus is said to resemble the snake-like hair of the mythological Greek Monster,

Medusa In Greek mythology, Medusa (; Ancient Greek: Μέδουσα "guardian, protectress"), also called Gorgo, was one of the three monstrous Gorgons, generally described as winged human females with living venomous snakes in place of hair. Those ...

. "Caput Medusae" atinmeans "Head of Medusa".

References

Veins of the torso {{Portal bar, Anatomy