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Budd-Chiari syndrome resulting from intrahepatic IVC compression secondary to blunt hepatic trauma
D J Markert1, K Shanmuganathan, S E Mirvis
1Department of Diagnostic Radiology, University of Maryland Medical Center Baltimore 21201, USA.
Insights
Budd-Chiari syndrome, a rare complication of abdominal trauma, can cause hepatic venous outflow obstruction. CT scans reveal intrahepatic inferior vena cava (IVC) compression by hematoma, aiding diagnosis and treatment.
Area of Science:
- Radiology
- Hepatology
- Trauma Surgery
Background:
- Hepatic venous outflow obstruction, or Budd-Chiari syndrome, is an uncommon consequence of abdominal trauma.
- Liver injury can lead to obstruction of the intrahepatic inferior vena cava (IVC).
Abstract:
Hepatic venous outflow obstruction (Budd-Chiari syndrome)is a rare sequel of abdominal trauma. Three cases of Budd-Chiari syndrome resulting from obstruction to the intrahepatic IVC by liver injury are reported. The CT findings include extrinsic compression of the intrahepatic inferior vena cava (IVC) by intraparenchymal and/or subcapsular hepatic haematoma, non-visualization or narrowing of one or more main hepatic veins with intravenous contrast-enhanced CT, and accumulation of low attenuation ascites. This entity should be distinguished from intraperitoneal bile leak or hemoperitoneum associated with major liver injury with which it could be confused. Decompression of the IVC and hepatic veins by surgical or percutaneous drainage of intrahepatic or subcapsular hematoma was curative in two of the three patients.