Budd-Chiari Syndrome

Question 1

What is wrong in Budd-Chiari Syndrome?

Causes

Answer 1

Budd-Chiari syndrome is hepatic vein thrombosis

It is usually seen in the context of underlying haematological disease or another procoagulant condition:

• polycythaemia rubra vera
• thrombophilia: activated protein C resistance, antithrombin III deficiency, protein C & S deficiencies
• pregnancy
• oral contraceptive pill

Question 2

Clinical Features

Answer 2

[What are the features of budd-chiari syndrome? I need to go down an academic PATH to tell you]

abdominal Pain
Ascites
Tender Hepatomegaly

Question 3

Investigation

Answer 3

Ultrasound with doppler flow

Question 4

Management

Answer 4

Transjugular intrahepatoportosystemic shunt (TIPPS)

Lifelong anticoagulation unless varices

Consider liver transplant if cirrhosis