Budd-Chiari syndrome: An unusual complication of an internal jugular tunneled dialysis catheter

Budd-Chiari syndrome due to the tip of an internal jugular tunneled dialysis catheter malposition in inferior vena cava or hepatic vein is a rare complication. We aimed to present our experience and compare it with the previous reports to highlight the clinical features and the optimal management. A 57-year-old female with history of ANCAp vasculitis, treated by hemodialysis in the last 2 years on a right internal jugular vein tunneled catheter was admitted for pain in the right upper quadrant. A subacute Budd-Chiari syndrome due to catheter malposition was diagnosed. The catheter was removed, and a new tunneled hemodialysis line was inserted in the right internal jugular vein with the tip at the junction of right atrium with superior vena cava. Anticoagulation with apixaban 2.5 mg twice daily was started after catheter replacement and the patient was discharged. At 1 month follow-up the patient had no symptoms, and the ultrasound revealed the absence of the thrombus in the inferior vena cava. Imagining monitoring for malposition after insertion or in a clinical context suggestive for Budd-Chiari syndrome is essential for early diagnosis and treatment. In our case, anticoagulation with apixaban and prompt catheter replacement resulted in Budd-Chiari syndrome resolution.

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

Vascular and Endovascular Surgery ◽

10.1177/15385744211002026 ◽

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.

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Intrahepatic Cholangiocarcinoma Presenting as the Budd-Chiari Syndrome: A Case Report and Literature Review

Canadian Journal of Gastroenterology ◽

10.1155/2005/943269 ◽

2005 ◽

Vol 19 (12) ◽

pp. 723-728 ◽

Cited By ~ 10

Author(s):

Joanna K Law ◽

Jenny Davis ◽

Anne Buckley ◽

Baljinder Salh

Keyword(s):

Inferior Vena Cava ◽

Intrahepatic Cholangiocarcinoma ◽

Inferior Vena ◽

Primary Tumour ◽

Vena Cava ◽

Biliary Tree ◽

Budd Chiari Syndrome ◽

Radiological Findings ◽

Chiari Syndrome ◽

The Right

Intrahepatic cholangiocarcinoma, an increasingly recognized primary tumour of the liver, is associated with a very poor prognosis. A patient with this tumour who presented with Budd-Chiari syndrome (the first to the authors' knowledge in Western literature and only the third patient overall) secondary to extensive thrombosis in his inferior vena cava extending from the right atrium down to his iliac vessels is described. Neither curative nor palliative intervention was deemed to be an option in this patient, who deteriorated rapidly while on anti-coagulants. Postmortem examination confirmed the radiological findings, and histological analysis revealed characteristic appearances of this tumour within the biliary tree and invasion into the inferior vena cava. Furthermore, biliary dysplasia, which can be a precursor to this cancer, was also noted within some of the bile ducts.

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Transdiaphragmatic cavoatrial anastomosis during orthotopic liver transplantation in a patient with chronic Budd-Chiari syndrome and thrombosis of inferior vena cava proximal to the right atrium - case report and review of literature

Journal of Translational Medicine and Research ◽

10.21614/jtmr-20-1-27 ◽

2015 ◽

Vol 20 (1) ◽

pp. 26

Author(s):

Vladislav Braşoveanu ◽

Emil Matei ◽

Mihnea Ioan Ionescu ◽

Bogdan Rădulescu ◽

Speranţa Iacob ◽

...

Keyword(s):

Liver Transplantation ◽

Case Report ◽

Inferior Vena Cava ◽

Right Atrium ◽

Inferior Vena ◽

Vena Cava ◽

Review Of Literature ◽

Budd Chiari Syndrome ◽

Chiari Syndrome ◽

The Right

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Budd-Chiari syndrome due to giant hydatid cyst: a case report and brief literature review

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2712 ◽

2013 ◽

Vol 7 (06) ◽

pp. 489-493 ◽

Cited By ~ 4

Author(s):

Sami Akbulut ◽

Mehmet Yilmaz ◽

Aysegul Kahraman ◽

Sezai Yilmaz

Keyword(s):

Inferior Vena Cava ◽

Hydatid Cyst ◽

Hydatid Disease ◽

Inferior Vena ◽

Vena Cava ◽

Hepatic Veins ◽

Budd Chiari Syndrome ◽

Chiari Syndrome ◽

Hepatic Venous Outflow ◽

The Right

Budd-Chiari syndrome is an uncommon disorder characterized by the thrombotic or non-thrombotic obstruction of hepatic venous outflow anywhere along the venous course from the hepatic venules to the junction of the inferior vena cava and the right atrium. The etiology of Budd-Chiari syndrome is classified as primary, attributable to intrinsic intraluminal thrombosis or the development of venous webs; or secondary, caused by intraluminal invasion by a parasite or malignant tumor or extraluminal compression by an abscess, solid tumor, or cyst, such as a hydatid cyst. In this study, we present a case of a giant hydatid cyst manifesting Budd-Chiari syndrome symptoms and signs by compressing the inferior vena cava and hepatic veins. In brief, the case demonstrates that hydatid disease should be considered in the differential diagnosis of Budd-Chiari Syndrome in areas such as Turkey, where hydatid disease is endemic.

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Pre-operative and post-operative ultrasound evaluation of Budd Chiari syndrome due to coarctation of the inferior vena cava

Clinical Radiology ◽

10.1016/s0009-9260(88)80414-8 ◽

1988 ◽

Vol 39 (1) ◽

pp. 154-158 ◽

Cited By ~ 1

Author(s):

V JAYANTHI ◽

S VICTOR ◽

B DHALA ◽

A GAJARAJ ◽

N MADANAGOPALAN

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Budd Chiari Syndrome ◽

Ultrasound Evaluation ◽

Chiari Syndrome ◽

Operative Ultrasound

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Budd-Chiari syndrome due to segmental obstruction of the inferior vena cava successfully managed with endovascular stenting

MedPharmRes ◽

10.32895/ump.mpr.2.3.22 ◽

2018 ◽

Vol 2 (3) ◽

pp. 22-26

Author(s):

Uyen Vo ◽

Duc Quach ◽

Luan Dang ◽

Thao Luu ◽

Luan Nguyen

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Laboratory Data ◽

Transaminase Level ◽

Vena Cava ◽

Budd Chiari Syndrome ◽

Endovascular Stenting ◽

Massive Ascites ◽

Chiari Syndrome ◽

History Of

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.

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