Presentation
Weakness, easy fatigability and abdominal distension
Patient Data

CT scout image shows global abdominal distension with centrally located bowels suggesting marked ascites.

Ultrasonography revealed enlarged liver with heterogeneous parenchyma and no definite focal lesion. The IVC and hepatic veins appeared attenuated. Also, there is marked ascites.
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Triphasic CT study revealed enlarged cirrhotic liver with heterogeneous parenchyma; there are a central enhancement and peripheral ischemia giving the appearance of nutmeg liver. No focal lesion. The IVC and hepatic veins are attenuated and the spleen is enlarged. Also, there is marked ascites.
Case Discussion
Diagnosis: Budd-Chiari syndrome.