scholarly journals Impact of Structured Computerized Tomography Reporting on Quality of Budd-Chiari Syndrome

2021 ◽  
Vol 64 (2) ◽  
pp. 62-68
Author(s):  
Anagha Joshi ◽  
Ashwini Sankhe ◽  
Mohammad Salman Mapara ◽  
Mridula Muthe ◽  
Vikrant Firke
2020 ◽  
Vol 93 (1109) ◽  
pp. 20190847 ◽  
Author(s):  
Pankaj Gupta ◽  
Varun Bansal ◽  
Praveen Kumar-M ◽  
Saroj K Sinha ◽  
Jayanta Samanta ◽  
...  

Objective: To evaluate the sensitivity, specificity, and diagnostic odds ratio (DOR) of Doppler ultrasound, CT, and MRI in the diagnosis of Budd Chiari syndrome (BCS). Methods: We performed a literature search in PubMed, Embase, and Scopus to identify articles reporting the diagnostic accuracy of Doppler ultrasound, CT, and MRI (either alone or in combination) for BCS using catheter venography or surgery as the reference standard. The quality of the included articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: 11 studies were found eligible for inclusion. Pooled sensitivities and specificities of Doppler ultrasound were 89% [95% confidence interval (CI), 81–94%, I2 = 24.7%] and 68% (95% CI, 3–99%, I2 = 95.2%), respectively. Regarding CT, the pooled sensitivities and specificities were 89% (95% CI, 77–95%, I2 = 78.6%) and 72% (95% CI, 21–96%, I2 = 91.4%), respectively. The pooled sensitivities and specificities of MRI were 93% (95% CI, 89–96%, I2 = 10.6%) and 55% (95% CI, 5–96%, I2 = 87.6%), respectively. The pooled DOR for Doppler ultrasound, CT, and MRI were 10.19 (95% CI: 1.5, 69.2), 14.57 (95% CI: 1.13, 187.37), and 20.42 (95% CI: 1.78, 234.65), respectively. The higher DOR of MRI than that of Doppler ultrasound and CT shows the better discriminatory power. The area under the curve for MRI was 90.8% compared with 88.4% for CT and 86.6% for Doppler ultrasound. Conclusion: Doppler ultrasound, CT and MRI had high overall diagnostic accuracy for diagnosis of BCS, but substantial heterogeneity was found. Prospective studies are needed to investigate diagnostic performance of these imaging modalities. Advances in knowledge: MRI and CT have the highest meta-analytic sensitivity and specificity, respectively for the diagnosis of BCS. Also, MRI has the highest area under curve for the diagnosis of BCS.


2021 ◽  
Vol 2 (3) ◽  
pp. 4-7
Author(s):  
Niveditha Dileep ◽  
John Thomas ◽  
Jisha James ◽  
Abhijith V

Background: Budd Chiari Syndrome (BCS) is the king of disorders which will mimic other disorders like chronic biliary disease, constrictive pericarditis, sinusoidal obstruction syndrome and so on, as it be like that, it is less diagnosed and treated in many countries. The prevalence of BCS is one in one million population, so it is a very rare case therefore it should be treated properly because many disorders like hematologic or malignant disease are the complications of BCS [1], [2]. Objective: To access the clinical variants of BCS along with the similarities and differences in clinical presentation, diagnostic approaches, and general treatment pattern which mimic, BCS thus gives the physician a clear outline about those disorders. Method: A man of 42 years old having BCS was taken for the study to carry out the differences in clinical features of BCS which distinguish the mimicking disorders. Clinical presentations were noted. Laboratory tests and diagnostic tests showed that the patient is having comorbidities including fatty liver with cholelithiasis, mild splenomegaly, liver parenchyma diseases, large esophageal varies with signs of recent hemorrhage, port hypertensive gastropathy and minimal ascites [3]. Patient get discharged after feeling better. Result: This patient is having chronic BCS with DIPS dysfunction. The patient had no history of liver disease before diagnosing BCS. BCS is almost curable when it is diagnosed correctly as early as possible. If not diagnosed early and treated well, comorbidities will occur, and it will affect the patient quality of life. Discussion: Early detection and proper treatment will help to control the disease up to an extent. This is depending on the physician’s knowledge. Hence, this case study clearly explains the disorders which mimic BCS for better understanding.


Swiss Surgery ◽  
2001 ◽  
Vol 7 (3) ◽  
pp. 141-144
Author(s):  
Gygax ◽  
Berdat ◽  
Carrel

Wir berichten über einen Patienten mit Budd-Chiari Syndrom welcher unter intravenöser Antikoagulation eine Heparin induzierte Thrombozytopenie entwickelte. Die chirurgische Behandlung bestand aus einer dorsocranialen Leberresektion mit anschliessender hepato-atrialer Anastomose unter Verwendung der extrakorporellen Zirkulation. Die perioperative Antikoagulation wurde mittels Hirudin durchgeführt. Erstaunlicherweise wurde während der Operation eine Thrombusbildung im Kardiotomie-Reservoir der Herz-Lungenmaschine beobachtet, obwohl die intraoperativ gemessene Antikoagulationsparameter (ACT und aPTT) im therapeutischen Bereich waren. Mit einem zusätzlichen Bolus Hirudin in das extrakorporelles Circuit und dank Spülung des Reservoirs konnte die Operation ohne weitere thrombotische Ereignisse zu Ende geführt werden.


MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 22-26
Author(s):  
Uyen Vo ◽  
Duc Quach ◽  
Luan Dang ◽  
Thao Luu ◽  
Luan Nguyen

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.


1985 ◽  
Vol 21 (3) ◽  
pp. 473
Author(s):  
J H Lee ◽  
E K Kim ◽  
Y T Ko ◽  
Y Yoon ◽  
S W Lee ◽  
...  

1995 ◽  
Vol 32 (5) ◽  
pp. 763
Author(s):  
Moon Gyu Lee ◽  
Yong Ho Auh ◽  
Cheol Min Park ◽  
Gi Young Ko ◽  
Sang Hee Choi

2019 ◽  
Vol 98 (6) ◽  
pp. 239-244

Closures in the splanchnic venous system (SVS) represent a broad medical problem. Anatomically, individual or even multiple sections of SVS may be affected at the same time. Main sections of SVS include the venous liver outflow system, the portal vein, and the upper mesenteric vein and its basin. Thrombosis is clearly the predominant cause of closure. The closures can present as acute, subacute, chronic occult or chronic manifest. The main pathological and anatomical units are the Budd-Chiari syndrome (BCS), extrahepatic portal vein obstruction (EHPVO) and mesenteric vein thrombosis (MVT). Advanced laboratory, imaging and intervention methods substantially modify the approach to prevention, diagnosis and treatment; surgical approach also plays a role. The problem of SVS closures is interdisciplinary.


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