scholarly journals Budd-Chiari Syndrome Caused by TIPS Malposition: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
A. S. Katkar ◽  
Anderson H. Kuo ◽  
S. Calle ◽  
K. Gangadhar ◽  
K. Chintapalli
Keyword(s):  
Abdominal Distension ◽  
Caudate Lobe ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Venous Outflow ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Chiari Syndrome ◽  
Intrahepatic Portosystemic Shunt ◽  
Venous Outflow Obstruction

Budd-Chiari syndrome refers to hepatic pathology secondary to diminished venous outflow, most commonly associated with venothrombotic disease. Clinically, patients with Budd-Chiari present with hepatomegaly, ascites, abdominal distension, and pain. On imaging, Budd-Chiari syndrome is hallmarked by occluded IVC and or hepatic veins, caudate lobe enlargement, heterogeneous liver enhancement, intrahepatic collaterals, and hypervascular nodules. Etiopathological factors for Budd-Chiari syndrome include several systemic thrombotic and nonthrombotic conditions that can cause venous outflow obstruction at hepatic veins and/or IVC. While the transjugular intrahepatic portosystemic shunt (TIPS) is used as a treatment option for Budd-Chiari syndrome, Budd-Chiari syndrome is not a well-known complication of TIPS procedure. We report a case of Budd-Chiari syndrome that occurred in a transplanted cirrhotic liver from malpositioned proximal portion of the TIPS in IVC causing occlusion of the ostia of hepatic veins which was subsequently diagnosed on contrast-enhanced CT.

scholarly journals A young man with progressive jaundice and abdominal distension

2019 ◽  
Vol 2 (1) ◽  
pp. 6-8
Author(s):  
Sith Siramolpiwat ◽  
Tanabute Limprukkasem
Keyword(s):  
Abdominal Distension ◽  
Caudate Lobe ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Complete Obliteration ◽  
Chiari Syndrome ◽  
Life Threatening ◽  
Hepatic Venous Outflow ◽  
Complete Thrombosis ◽  
Upper Abdomen

Budd-Chiari syndrome (BCS) is a rare, life-threatening disease caused by obstruction of hepatic venous outflow. Common presentations are right upper quadrant pain, ascites, and hepatomegaly. A diagnosis of Budd-Chiari syndrome should be suspected when liver disease occurs in a patient with known risk factors for hypercoagulable state. We report a 22-years old transgender man presented with jaundice, marked ascites and hepatomegaly. Imaging studies showed complete thrombosis of all hepatic veins. Finally, he was diagnosed with Budd-Chiari syndrome with antiphospholipid syndrome.   Figure 1  ภาพ CT upper abdomen แสดงให้เห็น marked ascites with heterogeneous liver enhancement, complete obliteration of all hepatic, caudate lobe hypertrophy, small intrahepatic venous collateral และ small arterial enhancing nodules

Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

2021 ◽  
pp. 153857442110020
Author(s):  
Reza Talaie ◽  
Hamed Jalaeian ◽  
Nassir Rostambeigi ◽  
Anthony Spano ◽  
Jafar Golzarian
Keyword(s):  
Inferior Vena Cava ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Inferior Vena ◽  
Vena Cava ◽  
Portosystemic Shunt ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Intrahepatic Portosystemic Shunt ◽  
The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

Budd-Chiari Syndrome in Childhood Secondary to Inferior Vena Caval Obstruction

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 808-812
Author(s):  
Arvind Taneja ◽  
S. K. Mitra ◽  
P. D. Moghe ◽  
P. N. Rao ◽  
N. Samanta ◽  
...  
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Venous Outflow ◽  
Massive Ascites ◽  
Inferior Vena Caval ◽  
Uncommon Disease ◽  
Chiari Syndrome ◽  
Hepatic Venous Outflow

Budd-Chiari syndrome is an uncommon disease caused by an obstruction to hepatic venous outflow either at the level of the hepatic veins or in the hepatic part of the inferior vena cava. Clinically, it presents with ascites, abdominal pain, hepatomegaly, edema, and occasionally jaundice. The syndrome was first recognised by Lamboran1 in 1842 and later described by Budd2 in 1846 and Chiari3 in 1899. The syndrome is caused by obstruction to the hepatic veins. In the Fig 1. Photograph showing massive ascites and dilated superficial abdominal veins. majority of cases, the obstruction is ascribed to obliterative thrombophlebitis of unknown cause.4

scholarly journals The Spectrum of Histologic Findings in Hepatic Outflow Obstruction

2016 ◽  
Vol 141 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Raul S. Gonzalez ◽  
Michael A. Gilger ◽  
Won Jae Huh ◽  
Mary Kay Washington
Keyword(s):  
Portal Tract ◽  
Central Vein ◽  
Budd Chiari Syndrome ◽  
Outflow Obstruction ◽  
Venous Outflow ◽  
Ductular Reaction ◽  
Chiari Syndrome ◽  
Hepatic Venous Outflow ◽  
Venous Outflow Obstruction ◽  
Hematoxylin And Eosin

Context.—Cardiac hepatopathy and Budd-Chiari syndrome are 2 forms of hepatic venous outflow obstruction with different pathophysiology but overlapping histologic findings, including sinusoidal dilation and centrilobular necrosis. Objective.—To determine whether a constellation of morphologic findings could help distinguish between the 2 and could suggest the diagnoses in previously undiagnosed patients. Design.—We identified 26 specimens with a diagnosis of cardiac hepatopathy and 23 with a diagnosis of Budd-Chiari syndrome. Slides stained with hematoxylin and eosin and with trichrome were evaluated for several distinctive histologic findings. Results.—Features common to both forms of hepatic outflow obstruction included sinusoidal dilation and portal tract changes of fibrosis, chronic inflammation, and bile ductular reaction. Histologic findings significantly more common in cardiac hepatopathy included pericellular/sinusoidal fibrosis and fibrosis around the central vein. Only centrilobular hepatocyte dropout/necrosis was significantly more common in Budd-Chiari, regardless of duration. Conclusions.—The finding of pericellular/sinusoidal fibrosis in cardiac hepatopathy compared with Budd-Chiari is not unexpected, given the chronic nature of most cardiac hepatopathy. Portal tract changes are common in both forms of hepatic outflow obstruction and should not deter one from making the diagnosis of hepatic outflow obstruction. Fibrosis along sinusoids and around the central vein may be suggestive of cardiac hepatopathy in biopsies from patients without a prior diagnosis.

scholarly journals Living donor liver transplantation for Budd‒Chiari syndrome with right posterior segment graft and patch plasty using the superficial femoral vein: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Norikazu Une ◽  
Kazuaki Tokodai ◽  
Norifumi Kanai ◽  
Yoshikatsu Saitoh ◽  
Mineto Ohta ◽  
...  
Keyword(s):  
Femoral Vein ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Donor Liver ◽  
Venous Outflow ◽  
Superficial Femoral Vein ◽  
Donor Liver Transplantation ◽  
Chiari Syndrome ◽  
Hepatic Venous Outflow ◽  
Patch Plasty

Abstract Background In living donor liver transplantation (LDLT) for patients with Budd‒Chiari syndrome (BCS), there are several concerns about reconstruction of the inferior vena cava (IVC) and hepatic veins. Herein, we report the case of a patient with BCS who underwent LDLT with right posterior segment graft (RPSG) and patch plasty for reconstruction of the hepatic venous outflow, using the patient’s own superficial femoral vein (SFV). Case presentation A 19-year-old man, who was diagnosed with primary BCS, underwent LDLT. His main hepatic veins were totally obstructed, and membranous stenosis was seen in the IVC. The LDLT donor was his mother; however, liver volumetric analysis showed that only her RPSG was appropriate. In the recipient surgery, 16 cm of the left SFV was harvested and was cut longitudinally and opened. The right hepatic vein (RHV) of the RPSG was anastomosed to the sidewall of the SFV graft. After explantation of native diseased liver was completed, the stenotic and thickened wall of the IVC was widely resected, and a large anastomotic orifice was created. Patch cavoplasty was performed with the RHV‒SFV graft patch. After portal reperfusion started, hepatic venous outflow was satisfactory, and there was no venous graft congestion. Both his postoperative course and his long-term course after discharge were uneventful. Conclusions In LDLT for BCS patients, ingenuity is required for the reconstruction of venous outflow. The SFV patch can be safely harvested from liver transplant recipients and is suitable for venous reconstruction. In addition, RPSG is an alternative type of liver graft for LDLT if a conventional right- or left-lobe graft cannot be used.

Budd-Chiari Syndrome – A review of the diagnosis and management

2011 ◽  
Vol 10 (1) ◽  
pp. 5-9
Author(s):  
MA Fox ◽  
◽  
JA Fox ◽  
MH Davies ◽  
◽  
...  
Keyword(s):  
Liver Disease ◽  
Abdominal Discomfort ◽  
Budd Chiari Syndrome ◽  
Outflow Obstruction ◽  
Venous Outflow ◽  
Hepatic Venous Outflow Obstruction ◽  
Key Points ◽  
Chiari Syndrome ◽  
Hepatic Venous Outflow ◽  
Venous Outflow Obstruction

Budd-Chiari syndrome (BCS) is the liver disease resulting from hepatic venous outflow obstruction comprising a triad of abdominal discomfort, hepatomegaly and ascites. Advances in the management of this disorder over the last three decades have dramatically improved survival. We present a review of the management of BCS followed by a case which illustrates some key points in the diagnosis and treatment of this condition.

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