Hepatic Vein Obstruction is also referred to as Budd-Chiai Syndrome

Anatomic and physiologic changes are brought about by reduction of hepatic venous outflow.

Can see a blockage in the Hepatic Vein – this takes blood from the liver and returns it to the heart.

The result of this blockage is damage to the liver

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

25% have multiple disorders

Causes my be a tumor or a thrombi (blood clot)

dissection_of_liver_from_below

Symptoms:

  • Painful abdomen
  • Vomiting
  • Jaundice
  • Enlarged spleen
  • Ascites
  • In a more chronic form varices and hepatic coma may be possible.

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

Doppler Ultrasound can be helpful

Liver biopsy when appropriate

 

Treatment

*** Is dependent on cause

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