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Budd-Chiari syndrome.

Satya Ranjan Sutradhar1, S R Sutradhar, C B Sarker

  • 1Mymensingh Medical College, Mymensingh. srsutradhar@yahoo.com

Mymensingh Medical Journal : MMJ
|February 8, 2005
PubMed
Summary
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A 30-year-old male with chronic liver disease symptoms was diagnosed with Budd-Chiari Syndrome (BCS). Diagnostic imaging confirmed the rare liver vascular condition, managed solely with medication.

Area of Science:

  • Hepatology
  • Vascular Medicine
  • Internal Medicine

Background:

  • Budd-Chiari Syndrome (BCS) is a rare hepatic vascular disease characterized by obstruction of hepatic venous outflow.
  • Chronic liver disease (CLD) can present with overlapping symptoms, complicating diagnosis.

Observation:

  • A 30-year-old non-alcoholic male presented with abdominal swelling, leg edema, and upper abdominal pain.
  • Physical examination revealed signs suggestive of portal hypertension and liver dysfunction, including ascites, hepatosplenomegaly, gynaecomastia, and testicular atrophy.
  • A distinctive finding was engorged superficial abdominal veins with an upward venous flow pattern.

Findings:

  • The patient, previously treated for chronic liver disease (CLD), was diagnosed with Budd-Chiari Syndrome (BCS).

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  • Ultrasonography, liver scan, and Doppler studies confirmed the diagnosis of BCS.
  • Medical management with spironolactone and frusemide was initiated for symptom control.

    • Implications:

    • This case highlights the importance of considering BCS in patients with unexplained ascites and signs of portal hypertension, even with a prior CLD diagnosis.
    • Accurate diagnosis through imaging is crucial for appropriate management of BCS.
    • Medical therapy alone can be a viable management strategy for selected BCS patients.