Budd-Chiari syndrome: Difference between revisions
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==Background== | <languages/> | ||
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==Background== <!--T:1--> | |||
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[[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.)]] | [[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 | ||
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*Fulminant, acute, chronic, or asymptomatic. | *Fulminant, acute, chronic, or asymptomatic. | ||
==Clinical Features== | |||
==Clinical Features== <!--T:3--> | |||
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Classic triad: | Classic triad: | ||
#[[Abdominal pain]] | #[[Special:MyLanguage/Abdominal pain|Abdominal pain]] | ||
#[[Ascites]] | #[[Special:MyLanguage/Ascites|Ascites]] | ||
#[[Hepatomegaly]] | #[[Special:MyLanguage/Hepatomegaly|Hepatomegaly]] | ||
==Differential Diagnosis== <!--T:5--> | |||
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{{DDX RUQ}} | {{DDX RUQ}} | ||
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==Evaluation== <!--T:6--> | |||
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[[File:Buddchiari2.png|thumb|Budd–Chiari syndrome secondary to cancer, note clot in the inferior vena cava and the metastasis in the liver.]] | [[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 | *[[Special:MyLanguage/LFTs|LFTs]], BMP, LDH | ||
*[[RUQ ultrasound|Ultrasound]], retrograde angiography | *[[Special:MyLanguage/RUQ ultrasound|Ultrasound]], retrograde angiography | ||
*CT and MRI less sensitive | *CT and MRI less sensitive | ||
==Management== | |||
*Sodium restriction, [[diuretics]], [[anticoagulants]] | |||
*Venous shunts or [[TIPS]] | ==Management== <!--T:8--> | ||
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*Sodium restriction, [[Special:MyLanguage/diuretics|diuretics]], [[Special:MyLanguage/anticoagulants|anticoagulants]] | |||
*Venous shunts or [[Special:MyLanguage/TIPS|TIPS]] | |||
*Liver transplant | *Liver transplant | ||
==External Links== | ==Disposition== <!--T:10--> | ||
==See Also== <!--T:11--> | |||
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*[[Special:MyLanguage/Portal vein thrombosis|Portal vein thrombosis]] | |||
==External Links== <!--T:13--> | |||
==References== | ==References== <!--T:14--> | ||
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<references/> | <references/> | ||
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[[Category:GI]] | [[Category:GI]] | ||
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Latest revision as of 12:25, 7 January 2026
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
Disposition
See Also
External Links
References