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Síndrome de Budd-Chiari

Magdalena Meszaros1, Christophe Bureau2

  • 1Service d'hépato-gastro-entérologie et transplantation hépatique, CHU de Montpellier, Montpellier, France.

La Revue du praticien
|December 30, 2025
PubMed
Resumen

El síndrome de Budd-Chiari (SBC) implica el bloqueo del drenaje de las venas hepáticas. El diagnóstico y tratamiento tempranos, incluida la anticoagulación y el abordaje de las causas, mejoran significativamente las tasas de supervivencia.

Palabras clave:
Síndrome de Budd-Chiariangiopathy

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Área de la Ciencia:

  • Hepatología
  • Medicina Vascular
  • Gastroenterología

Sus antecedentes:

  • El síndrome de Budd-Chiari (SBC) es una afección rara que implica la obstrucción del flujo de salida venoso hepático.
  • La evaluación etiológica de los trastornos protrombóticos es crucial en el diagnóstico del SBC.
  • Los trastornos mieloproliferativos son la causa más común, y se encuentran en más del 40% de los casos.

Objetivo del estudio:

  • Describir las estrategias diagnósticas y terapéuticas para el síndrome de Budd-Chiari.
  • Enfatizar la importancia de identificar las condiciones protrombóticas subyacentes.
  • Destacar el pronóstico mejorado con los enfoques de manejo modernos.

Principales métodos:

  • El diagnóstico se basa en la imagenología, en particular la ecografía abdominal con Doppler.
  • La evaluación etiológica busca sistemáticamente trastornos protrombóticos.
  • El enfoque terapéutico combina el manejo médico y las estrategias para restaurar el flujo venoso.

Principales resultados:

  • La presentación clínica del SBC es muy variable.
  • Un enfoque terapéutico progresivo ha mejorado el pronóstico del paciente.
  • Las tasas de supervivencia general a 5 años ahora superan el 80% con un manejo adecuado.

Conclusiones:

  • El síndrome de Budd-Chiari requiere una investigación etiológica sistemática y una estrategia terapéutica progresiva.
  • El manejo debe centrarse en la anticoagulación, el tratamiento de las causas subyacentes y la restauración del flujo venoso hepático.
  • El seguimiento a largo plazo es esencial debido a los riesgos de nódulos hepáticos y carcinoma hepatocelular.