Related Experiment Videos
[Budd-Chiari syndrome illustrated by four case reports]
Henning Grønbaek1, Dennis Tønner Nielsen, Lone Bording Astrup
1Medicinsk afdeling V og radiologisk afdeling R, Arhus Kommunehospital, Arhus Universitetshospital, DK-8000 Arhus C. henning.gronbaek@dadlnet.dk
Insights
Budd-Chiari syndrome (BCS) management requires individualized treatment plans. Diverse patient cases highlight successful interventions including TIPS, venesection, anticoagulation, liver transplantation, and stenting for hepatic venous obstruction.
Area of Science:
- Hepatology
- Vascular Medicine
- Interventional Radiology
Background:
- Budd-Chiari syndrome (BCS) is characterized by hepatic venous outflow obstruction.
- Patient management is complex due to variations in obstruction location, etiology, and disease progression.
Observation:
- Four distinct BCS cases were presented.
- Case 1: Protein C deficiency, oral contraceptive use, smoking; treated with transjugular intrahepatic portosystemic shunt (TIPS).
- Case 2: Polycythemia vera; treated with venesection and anticoagulation.
- Case 3: Underwent liver transplantation.
- Case 4: Congenital vascular web; treated with stenting.
Findings:
- Successful outcomes were achieved with tailored interventions for each patient.
- Transjugular intrahepatic portosystemic shunt (TIPS) proved effective for a patient with multiple risk factors.
- Medical management (venesection, anticoagulation) and surgical options (liver transplant, stenting) were successful in other cases.
Implications:
- Individualized treatment strategies are crucial for managing Budd-Chiari syndrome.
- A range of interventional and surgical options can effectively address hepatic venous obstruction.
- Understanding patient-specific factors is key to selecting the optimal therapeutic approach for BCS.
Abstract:
Budd-Chiari syndrome (BCS) represents obstruction of hepatic venous drainage. Patients with BCS must be managed individually, because the localisation of the obstruction, the cause, and natural history of the specific lesion differ between patients. We report four cases of Budd-Chiari syndrome where the first patient (who was protein C-deficient, took an oral contraceptive, and smoked) was successfully treated with transjugular intrahepatic portosystemic shunt (TIPS), the second patient (with polycythaemia vera) was treated with venesection and anticoagulation, the third patient underwent a successful liver transplantation. The last patient had a congenital vascular web and was treated by stenting.