Acute Budd-Chiari syndrome

Case contributed by Dr Bita Abbasi

Presentation

Young female presenting with abdominal pain and distention.

Patient Data

Age: 28 years
Gender: Female
CT

Contrast enhanced abdomino-pelvic CT scan in the portovenous phase shows lack of enhancement of hepatic veins, filling defects in the IVC and ascites. There is reduced and heterogeneous enhancement of liver parenchyma with sparing of caudate lobe.  This finding is seen due to separate venous drainage of this liver segment.

Splenomegaly . 

Annotated image

Annotated images

Case Discussion

Acute Budd-Chiari syndrome is caused by thrombosis of hepatic veins and/or suprahepatic IVC. Occlusion of hepatic veins and severe ascites are the typical findings in acute Budd-Chiari syndrome. Liver parenchymal congestion leads to decreased and heterogenous liver enhancement, with the typical sparing of caudate lobe that is drained directly into the IVC. Thrombosis may extend into the IVC, as is seen in this case. The patent IVC may also be compressed by the enlarged caudate lobe. 

Splenomegaly and concurrent portal hypertension are common associations. 

PlayAdd to Share

Case information

rID: 60858
Published: 5th Jun 2018
Last edited: 6th Jun 2018
Inclusion in quiz mode: Included
Institution: Mashhad university of medical science

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.