Liver: Budd-Chiari Syndrome
Budd-Chiari Syndrome
Basics
- Hepatic Vein Obstruction
- Most Common Cause:
- West: Polycythemia Vera & Hypercoagulable Disorders
- East: Membranous Webs
Presentation
- Classic Triad:
- Abdominal Pain
- Ascites (Most Common Symptom)
- Hepatomegaly
- Varices
- Portal Hypertension
- Cirrhosis
- Liver Failure
Diagnosis
- Dx: Doppler US
Treatment
- Primary Tx: Heparin & Angioplasty/Stent (If Amenable)
- If Well-Defined Acute Clot: Thrombolytics
- Must Be < 3-4 Weeks (Will Become Organized with Surrounding Fibrosis)
- If Fails: TIPS or Liver TXP (Most Effective Tx)
- If Well-Defined Acute Clot: Thrombolytics