the prominent veins on her anterior abdominal wall (called caput
medusae) may be a site of portal hypertension as blood backs up within the
hepatic portal system and uses alternative routes, rather than through the
liver, to return to the systemic circulatory system. In addition to prominent
abdominal veins, portal hypertension may also cause esophageal varices
and hemorrhoids. Splenomegaly (answer a)would be palpated on the left
side. While both the gall bladder and appendix are on the right side of the
abdomen, both cholecystitis (answer d)and appendicitis (answer c)
should result in abdominal pain, which is absent in this patient. An
abdominal aortic aneurysm (answer e)would normally appear in the mid-
line and pulsate.
530 Anatomy, Histology, and Cell Biology