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.
Most Common Symptoms Include:
– Abdominal Pain
– Weight loss
– Enlarged spleen
– Swelling in the lower Extremities (Edema)
– In a more chronic form varices and hepatic coma may be possible.
– Identifiable cause can not be found in every patient
– Thrombosis – primary cause (75%)
– Thrombosis (blood clot) found in hepatic vein
– Secondary (25%)
– Postpartum state
– Polycythemia Vera
– Oral Contraceptive use
– Liver Cancer
– Lupus anticoagulant
– Physical Exam – Initial Evaluation
– Blood work
– Doppler Ultrasound can be helpful
– CT/MRI of abdomen
– Liver biopsy when appropriate
*** Is largely dependent on the cause
– Ascites – treat with fluid and salt retention and diuretic
– TIPS procedure placement in certain individuals
– Anticoagulation medication