Related Experiment Videos
Hepatic-pericardio-phrenic collateral (natural shunt) in a patient with Budd-Chiari syndrome
J B Dilawari1, N Nagpal, Y K Chawla
1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Budd-Chiari syndrome (BCS) can cause portal hypertension. A BCS patient presented with a rare, large transdiaphragmatic collateral vein that successfully decompressed esophageal varices, a finding not previously documented.
Area of Science:
- Hepatology
- Vascular Surgery
- Gastroenterology
Background:
- Budd-Chiari syndrome (BCS) involves hepatic venous outflow obstruction, leading to portal hypertension.
- Development of collateral vessels is a common compensatory mechanism in BCS.
- Esophageal varices are a serious complication of portal hypertension.
Observation:
- A case of BCS is presented with an exceptionally large transdiaphragmatic collateral.
- This collateral connected the left hepatic vein to the left innominate vein.
- The collateral effectively reduced pressure and decompressed esophageal varices.
Findings:
- The identified transdiaphragmatic collateral represents a unique anatomical pathway for venous decompression in BCS.
- This collateral's size and function in decompressing esophageal varices are unprecedented in medical literature.
- The case highlights potential alternative venous drainage pathways in complex hepatic outflow obstruction.
Implications:
- This finding may offer new insights into the management of BCS and its complications.
- Understanding such rare collaterals could inform surgical or interventional strategies.
- Further research into similar anatomical variations could expand treatment options for portal hypertension.
Abstract:
Hepatic venous outflow tract obstruction, Budd-Chiari syndrome (BCS), leads to portal hypertension and to the development of collaterals that bypass the obstruction. Described here is a BCS patient with an unusually large transdiaphragmatic collateral between the left hepatic and left innominate veins, which decompressed the oesophageal varices. This has not been reported earlier in the literature.