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Budd-Chiari syndrome--a case report.

Binaya Khanal1, Basudev Pudasaini, Rikesh Tamrakar

  • 1Trinity health international, Michigan, Republic of Marshall Islands.

Nepal Medical College Journal : NMCJ
|November 22, 2005
PubMed
Summary

A young man with nephrotic syndrome developed Budd-Chiari syndrome, characterized by liver and inferior vena cava (IVC) thrombosis. A portocaval shunt provided significant relief from abdominal symptoms.

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Area of Science:

  • Hepatology
  • Vascular Surgery
  • Nephrology

Background:

  • Budd-Chiari syndrome is a rare condition caused by hepatic venous outflow obstruction.
  • Nephrotic syndrome is a potential risk factor for hypercoagulability and thrombosis.

Observation:

  • A 21-year-old male presented with chronic abdominal pain, distension, and lower limb swelling.
  • Abdominal ultrasonography revealed a coarse liver echotexture and an inferior vena cava (IVC) filling defect.
  • CT scan confirmed IVC thrombus and an enlarged caudate lobe, suggesting Budd-Chiari syndrome.

Findings:

  • Inferior venacavography confirmed the diagnosis of Budd-Chiari syndrome.
  • Nephrotic syndrome was identified as the underlying risk factor for thrombosis.
  • Surgical intervention with a portocaval shunt successfully decompressed the portal system.

Implications:

  • This case highlights the importance of considering Budd-Chiari syndrome in young patients with nephrotic syndrome presenting with abdominal symptoms.
  • Portocaval shunt surgery can be an effective treatment for Budd-Chiari syndrome, alleviating portal hypertension and improving patient outcomes.
  • Early diagnosis and risk factor management are crucial for managing Budd-Chiari syndrome and preventing complications.

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