Budd-Chiari syndrome: Difference between revisions
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==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.)]] | [[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: | Classic triad: | ||
#[[Abdominal pain]] | #[[Special:MyLanguage/Abdominal pain|Abdominal pain]] | ||
#[[Ascites]] | #[[Special:MyLanguage/Ascites|Ascites]] | ||
#[[Hepatomegaly]] | #[[Special:MyLanguage/Hepatomegaly|Hepatomegaly]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{DDX RUQ}} | {{DDX RUQ}} | ||
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==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.]] | [[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== | ==Management== | ||
*Sodium restriction, [[diuretics]], [[anticoagulants]] | |||
*Venous shunts or [[TIPS]] | *Sodium restriction, [[Special:MyLanguage/diuretics|diuretics]], [[Special:MyLanguage/anticoagulants|anticoagulants]] | ||
*Venous shunts or [[Special:MyLanguage/TIPS|TIPS]] | |||
*Liver transplant | *Liver transplant | ||
==Disposition== | ==Disposition== | ||
==See Also== | ==See Also== | ||
*[[Portal vein thrombosis]] | |||
*[[Special:MyLanguage/Portal vein thrombosis|Portal vein thrombosis]] | |||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] | ||
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Revision as of 21:45, 4 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