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[Budd-Chiari syndrome secondary to post-traumatic stenosis of the inferior vena cava]
Insights
Budd-Chiari syndrome can rarely stem from abdominal trauma, causing inferior vena cava stenosis. Histological analysis revealed dense fibrous tissue, distinguishing it from membranous obstruction and confirming a traumatic origin.
Area of Science:
- Vascular Surgery
- Hepatology
- Trauma Surgery
Background:
- Budd-Chiari syndrome (BCS) typically results from inferior vena cava (IVC) obstruction, often membranous.
- Traumatic IVC lesions leading to BCS are exceptionally rare.
Observation:
- A 29-year-old male presented with BCS 3 years post-abdominal trauma.
- Cavography revealed 50% stenosis in the suprahepatic IVC.
- Percutaneous transluminal angioplasty failed twice; surgical resection was performed.
Findings:
- Histological examination of the stenotic IVC segment showed dense fibrous tissue replacing the venous wall layers.
- Absence of inflammation or thrombosis was noted.
- This distinct histological pattern differentiates traumatic stenosis from membranous obstruction, where the venous wall structure is preserved.
Implications:
- Histological assessment is crucial for diagnosing the traumatic etiology of IVC stenosis in BCS.
- This case expands the understanding of rare causes of BCS and IVC stenosis.
- Highlights the importance of considering trauma history in BCS diagnosis and management.
Abstract:
Budd-Chiari syndrome with inferior vena cava involvement is usually due to membranous obstruction; traumatic origin of inferior vena cava lesions is very rare. We report a case of Budd-Chiari syndrome in a 29 year-old man, 3 years after an abdominal trauma. Cavography showed 50% stenosis in the sushepatic portion of the inferior vena cava. After two unsuccessful percutaneous transluminal angioplasty procedures, a surgical resection of the stenotic vein was performed. The histological study of the stenotic segments showed that the three layers of the venous wall had been replaced by a dense fibrous tissue. No inflammation or thrombosis were found. This case of stenosis of the vena cava shows that histological examination can be used to assess the traumatic nature of the lesion, showing a different histological pattern from that of the membranous obstruction in which the basic structure of the venous wall is preserved.