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The Budd-Chiari syndrome revisited
M Shill1, J M Henderson, A S Tavill
1Friedman Center for Digestive and Liver Disorders, Mt. Sinai Medical Center, Case Western Reserve University, Cleveland, OH 44106.
The Gastroenterologist
|March 1, 1994
Summary
Budd-Chiari syndrome, a hepatic venous outflow obstruction, is often linked to thrombogenic disorders. Advances in Doppler ultrasound and interventional procedures offer new diagnostic and management strategies for this condition.
Area of Science:
- Hepatology
- Vascular Surgery
- Interventional Radiology
Background:
- Budd-Chiari syndrome involves hepatic venous outflow obstruction.
- A significant percentage of cases are associated with underlying thrombogenic disorders.
Purpose of the Study:
- To review recent advances in the diagnosis and treatment of Budd-Chiari syndrome.
- To highlight the role of thrombogenic disorders in its etiology.
Main Methods:
- Doppler ultrasound for initial imaging of hepatic veins and flow.
- Angiography with pressure measurements and liver biopsy for management decisions.
- Interventional techniques including angioplasty and shunt placement.
Main Results:
- Doppler ultrasound is crucial for diagnosing hepatic vein abnormalities.
- Nonsurgical options like angioplasty and transjugular intrahepatic portosystemic shunts are effective.
- Decompressive shunts and liver transplantation remain vital for specific patient groups.
Conclusions:
- Early diagnosis and identification of thrombogenic causes are key.
- A multimodal approach combining imaging, interventional radiology, and surgery improves outcomes.
- Liver transplantation is a life-saving option for advanced disease.