Post-gravidic Budd-Chiari syndrome treated by mesocaval H-graft shunt

A new case of Budd-Chiari syndrome following pregnancy is reported. The patient, shortly after her second normal delivery, showed clinical evidence of hepatic venous outflow impairment. The diagnosis of Budd-Chiari syndrome was supported by angiographic studies, computed tomography, liver scanning and histology. Because of the poor results reported in the literature following medical treatment, portosystemic shunting was considered. At laparotomy, due to the huge caudate lobe hypertrophy, a mesocaval H-graft shunt was performed, using a 10 mm woven Impraflex graft. The patient is well, with normal liver function tests, 24 months following the procedure.