Budd-Chiari syndrome

Background

Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. (Hepatic veins labeled at center top.)
  • Rare
  • Caused by occlusion of hepatic veins, 75% primary (thrombosis), 25% secondary (compression by mass)
  • Fulminant, acute, chronic, or asymptomatic.

Clinical Features

Classic triad:

  1. Abdominal pain
  2. Ascites
  3. Hepatomegaly

Differential Diagnosis

RUQ Pain

Evaluation

Budd–Chiari syndrome secondary to cancer, note clot in the inferior vena cava and the metastasis in the liver.
  • LFTs, BMP, LDH
  • Ultrasound, retrograde angiography
  • CT and MRI less sensitive

Management

Disposition

See Also

External Links

References