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Updated: Jun 2, 2026

Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma

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Budd-Chiari syndrome: two cases with different courses.

Shinjiro Inomata¹, Yasuaki Takeyama, Takashi Tanaka

¹Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan.

Case Reports in Gastroenterology

|April 15, 2011

Summary

This report details two Budd-Chiari syndrome cases with atypical presentations. Effective treatment for one patient with inferior vena cava obstruction highlights the need for careful monitoring in all cases.

Keywords:

Antiphospholipid syndrome Budd-Chiari syndrome Hepatocellular carcinoma Membranous obstruction of the inferior vena cava Percutaneous transluminal angioplasty Restenosis

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Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma

Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma

Published on: February 13, 2026

Area of Science:

Hepatology
Vascular Medicine
Internal Medicine

Background:

Budd-Chiari syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction.
Diagnosis and management can be challenging due to diverse clinical presentations.
Understanding atypical BCS presentations is crucial for timely intervention.

Observation:

Case 1: A 57-year-old male with inferior vena cava (IVC) obstruction, antiphospholipid syndrome, hepatitis C, and alcohol abuse presented with edema and varices.
Case 2: A 73-year-old female with membranous IVC obstruction presented with abdominal pain but no edema or varices.
Both cases displayed atypical features, with liver biopsy findings not correlating directly with clinical presentation or obstruction severity.

Findings:

Case 1: Percutaneous transluminal angioplasty and anticoagulation ameliorated symptoms, with no restenosis at 9 months.
Case 2: Membranous IVC obstruction required no intervention, with preserved liver function despite congestion.
Histopathological findings in both cases were atypical relative to clinical and imaging data.

Implications:

These cases underscore the importance of integrating clinical, imaging, and histopathological data for accurate BCS diagnosis and management.
Atypical presentations necessitate vigilant follow-up for potential complications like hepatocellular carcinoma.
Successful intervention in complex BCS cases can lead to significant symptom improvement and prevent disease progression.