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Transhepatic venous collaterals in a patient with the Budd-Chiari syndrome
P L Redmond1, S Kadir, J L Cameron
1Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Insights
A patient with inferior vena cava occlusion developed Budd-Chiari syndrome. A mesoatrial shunt successfully treated the condition, leading to complete recovery and resolving ascites and edema.
Area of Science:
- Vascular surgery
- Hepatology
- Interventional radiology
Background:
- Inferior vena cava (IVC) occlusion can obstruct hepatic venous outflow.
- Budd-Chiari syndrome (BCS) is a rare hepatic vascular disease caused by hepatic venous obstruction.
- Transhepatic venous collaterals can form to bypass IVC obstructions.
Observation:
- A patient presented with a short IVC occlusion.
- Large transhepatic venous collaterals developed between the right and middle hepatic veins.
- Hepatic vein obstruction led to BCS, ascites, and crural edema.
Findings:
- The patient's BCS was successfully managed with a mesoatrial shunt.
- The shunt effectively restored hepatic venous outflow.
- Complete clinical recovery was achieved post-procedure.
Implications:
- Mesoatrial shunts are a viable treatment option for BCS secondary to IVC occlusion.
- Early intervention can prevent severe complications of BCS.
- Understanding collateral pathways is crucial for managing IVC obstructions.
Abstract:
A patient with large transhepatic venous collaterals between the right and middle hepatic veins bypassing a short inferior vena caval occlusion is described. Obstruction of the hepatic veins led to the development of the Budd-Chiari syndrome, ascites, and crural edema. A mesoatrial shunt was performed which resulted in complete recovery.