Hepatic Vein Obstruction (HVT) is also referred to as Budd-Chiai Syndrome. It is an Anatomic and physiologic change that are brought about by reduction of hepatic venous outflow to the liver.

A blockage can be seen in the Hepatic Vein and this takes blood from the liver and returns it prematurely to the heart. The result of this reversal and blockage is a severe damage to the liver.

75% is associated with predisposing factors of hereditary and acquitted hypercoagulable states.

25% have multiple disorders

One of the more common cause, my be a tumor or a thrombi (blood clot) that becomes lodged.

dissection_of_liver_from_below

Most Common Symptoms Include:

–  Abdominal Pain
–  Weight loss
–  Vomiting
–  Nausea
–  Jaundice
–  Enlarged spleen
–  Ascites
–  Swelling in the lower Extremities (Edema)
–  In a more chronic form varices and hepatic coma may be possible.

Potential Causes

–  Identifiable cause can not be found in every patient
–  Thrombosis – primary cause  (75%)
–  Thrombosis (blood clot) found in hepatic vein
–  Secondary  (25%)
–  Pregnancy
–  Postpartum state
–  Polycythemia Vera
–  Oral Contraceptive use
–  Liver Cancer
–  Lupus anticoagulant
–  Tuberculosis
–  Others

Diagnosis

–  Physical Exam – Initial Evaluation
–  Blood work
–  Doppler Ultrasound can be helpful
–  CT/MRI of abdomen
–  Liver biopsy when appropriate

Treatment

*** Is largely dependent on the cause

–  Ascites – treat with fluid and salt retention and diuretic
–  TIPS procedure placement in certain individuals
–  Anticoagulation medication

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