Case ReportSuccessful treatment of chronic Budd-Chiari syndrome with a transjugular intrahepatic portosystemic shunt
Section snippets
Case Report
In April 1994, a 23-year-old woman was referred to our hospital with a 3-week history of abdominal distension, right upper quadrant pain, nausea and vomiting. Her past medical history was remarkable for use of oral contraceptives for 4 years.
On examination, the patient had marked hepatosplenomegaly and ascites. At that time, the complete blood cell count (CBC) including platelets (430 000/mm3) and chemistry were normal. The liver profile showed moderate elevation of transaminases, total
Discussion
The Budd-Chiari syndrome (BCS) results from obstruction of the hepatic venous outflow tract due to occlusion of the hepatic veins and/or the IVC. The pathophysiologic features in acute BCS are caused by the inability of blood to drain from the liver, which leads to hepatic congestion, ischemia, and death of pericentral hepatocytes. Eventually, chronic liver disease develops and is followed by features of portal hypertension and cirrhosis. Due to separate drainage into the IVC by small and
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Cited by (46)
Role of radiological imaging and interventions in management of Budd–Chiari syndrome
2018, Clinical RadiologyCitation Excerpt :TIPSS placement is not only recommended in patients with failed thrombolytic therapy, with poor hepatic reserve, with an occluded IVC, but also in acute emergent conditions. TIPSS serves to provide a bridge to liver transplantation and the shunt provides ample time to allow for development of collaterals.42,60,61 In case of occurrence of variceal bleeding in acute and chronic BCS, TIPSS may be contemplated as the first line of treatment.24
Chapter 88-Budd-Chiari syndrome and veno-occlusive disease
2016, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas: Sixth EditionChapter 77 - Budd-Chiari syndrome and venoocclusive disease
2012, Blumgart's Surgery of the Liver, Biliary Tract and PancreasBudd-Chiari Syndrome and Veno-occlusive Disease
2006, Surgery of the Liver, Biliary Tract and Pancreas: Volumes 1-2, Fourth EditionThe Effect of Initial Shunt Outflow Position on Patency of Transjugular Intrahepatic Portosystemic Shunts
2004, Journal of Vascular and Interventional Radiology