Revealing an Exceptional Case of Budd-Chiari Syndrome

Budd-Chiari syndrome (BCS) is a rare disorder characterized by hepatic venous outflow obstruction, leading to substantial effects, which include liver congestion, ascites, and liver failure. This is an unusual but very important form of secondary BCS caused by extraluminal compression from structures such as abscesses, tumors, or cysts. This case study exemplifies a 46-year-old female with no previous medical history who developed BCS due to the encasement of the IVC and hepatic veins secondary to a hydatid cyst, which is an uncommon presentation. Distension, ascites, and pain in the abdomen are the chief complaints. Investigations were positive for a hydatid cyst in the liver on imaging and serology, as well as features commensurate with BCS. The patient received conservative management with albendazole and anticoagulation. However, she refused cyst surgical resection and thus died three weeks after her discharge because of a cardiorespiratory arrest possibly associated with complications of her hydatid cyst like anaphylaxis secondary to rupture of the hydatid cyst. Therefore, this case brings out the significance of considering hydatid cysts when making a differential diagnosis on patients suffering from BCS, especially in endemic areas, and also underscores the importance of early recognition, treatment measures, and education to avoid fatal conditions.