Budd-Chiari syndrome
Background
Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. (Hepatic veins labeled at center top.)
- Rare
- Caused by occlusion of hepatic veins, 75% primary (thrombosis), 25% secondary (compression by mass)
- Fulminant, acute, chronic, or asymptomatic.
Clinical Features
- Classic triad:
Differential Diagnosis
- Hepatitis
- Cirrhosis
Evaluation
Budd–Chiari syndrome secondary to cancer, note clot in the inferior vena cava and the metastasis in the liver.
- LFTs, BMP, LDH
- Ultrasound, retrograde angiography
- CT and MRI less sensitive
Management
- Sodium restriction, diuretics, anticoagulants
- Venous shunts or TIPS
- Liver transplant
See Also
References
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