Budd-Chiari syndrome: Difference between revisions
| (5 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
[[File:Gray1121.png|thumb|Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. (Hepatic veins labeled at center top.)]] | |||
*Rare | *Rare | ||
*Caused by occlusion of hepatic veins, 75% primary (thrombosis), 25% secondary (compression by mass) | *Caused by occlusion of hepatic veins, 75% primary (thrombosis), 25% secondary (compression by mass) | ||
*Fulminant, acute, chronic, or asymptomatic. | *Fulminant, acute, chronic, or asymptomatic. | ||
==Clinical Features== | ==Clinical Features== | ||
Classic triad: | |||
#[[Abdominal pain]] | |||
#[[Ascites]] | |||
#[[Hepatomegaly]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{DDX RUQ}} | |||
==Evaluation== | ==Evaluation== | ||
[[File:Buddchiari2.png|thumb|Budd–Chiari syndrome secondary to cancer, note clot in the inferior vena cava and the metastasis in the liver.]] | |||
*[[LFTs]], BMP, LDH | *[[LFTs]], BMP, LDH | ||
*[[RUQ ultrasound|Ultrasound]], retrograde angiography | *[[RUQ ultrasound|Ultrasound]], retrograde angiography | ||
| Line 25: | Line 28: | ||
==See Also== | ==See Also== | ||
[[Portal vein thrombosis]] | *[[Portal vein thrombosis]] | ||
==External Links== | ==External Links== | ||
Latest revision as of 23:01, 28 February 2024
Background
- 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
RUQ Pain
- Gallbladder disease
- Pancreatitis
- Acute hepatitis
- Pancreatitis
- GERD
- Appendicitis (retrocecal)
- Pyogenic liver abscess
- Bowel obstruction
- Cirrhosis
- Budd-Chiari syndrome
- GU
- Other
- Hepatomegaly due to CHF
- Peptic ulcer disease with or without perforation
- Pneumonia
- Herpes zoster
- Myocardial ischemia
- Pulmonary embolism
- Abdominal aortic aneurysm
Evaluation
- LFTs, BMP, LDH
- Ultrasound, retrograde angiography
- CT and MRI less sensitive
Management
- Sodium restriction, diuretics, anticoagulants
- Venous shunts or TIPS
- Liver transplant