Budd-Chiari Syndrome With Spontaneous Intrahepatic Portosystemic Shunts: A Case Series

Area of Science:

• Hepatology
• Vascular Medicine
• Radiology

Background:

• Intra-hepatic portal-venous collaterals are a hallmark of Budd-Chiari syndrome (BCS).
• These collaterals are typically small and visualized via Doppler ultrasound.
• Established treatments for BCS involve creating large portal-systemic shunts.

Purpose of the Study:

• To report rare cases of asymptomatic Budd-Chiari syndrome.
• To describe the occurrence of spontaneous large intra-hepatic portal-systemic shunts in these patients.

Main Methods:

• Case series review.
• Analysis of imaging findings (Doppler, CT, MRI).
• Clinical data assessment.

Main Results:

• Three patients with asymptomatic Budd-Chiari syndrome were identified.
• All three patients presented with spontaneous, large intra-hepatic portal-systemic shunts.
• These shunts were not surgically or radiologically created.

Conclusions:

• Spontaneous large intra-hepatic portal-systemic shunts can occur in asymptomatic Budd-Chiari syndrome.
• This finding represents a rare variation in the typical presentation and management of BCS.
• Further research may explore the implications and outcomes of such spontaneous shunts.