Budd-Chiari Syndrome following Pregnancy. Report of 16 Cases, with Roentgenological, Hemodynamic, and Histological Studies of the Hepatic Outflow Tract

Khuroo, Mohammad Sultan; Datta, D. V.

doi:10.1097/00006254-198009000-00008

Cited by 40 publications

(61 citation statements)

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“…This was in contrast to the initial study period (before 2001), during which few tests were performed, where etiology was evident only in 28.5% cases. None of our patients were pregnant, taking oral contraceptive pills, in a post-partum state, had abdominal trauma, abdominal surgery, amoebic liver abscess, pyogenic liver abscess, hydatid cyst, hepatic tuberculosis or filariasis; these were the predominant causes in the previous Indian studies [9,[12][13][14][15][16][17][18][19][20]23,42] . Previous Indian series (before the year 2001) have shown identification of underlying etiology in 12%-50%, of which hypercoagulable states were uncommon [9,[12][13][14][15]42] .…”

Section: Discussionmentioning

confidence: 99%

“…Previously, MOVC was thought to be the predominant cause of IVC involvement (20.4%-58.6%) and of BCS in India [6,7,[11][12][13][14][15]17,29,35,39] , as well as in Asian countries [49,50,53] . In two recent Indian studies, MOVC was present in 0% and 17.2%, while IVC involvement was seen in 56.2% and 62% cases, respectively [24,40] .…”

Section: Discussionmentioning

confidence: 99%

“…In our series, IVC involvement in the majority of cases was due to IVC thrombosis. Previously, MOVC and IVC thrombosis were considered to be idiopathic in origin by most Indian and Asian workers [5,6,11,[13][14][15]17,35,49,50,53,54] ; but this view has been challenged recently in a few reports [22,29,30,42,[55][56][57][58] . In cases of IVC thrombosis in our study, the etiology was identified in 50%.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the western world, in the Indian series, there is a striking predominance of IVC obstruction (mainly from membrane or web) or combined IVC-HV obstruction rather than HV obstruction alone [12][13][14][15] . Tumors, pregnancy, oral contraceptive pills (OCP) and infections were proposed as predominant underlying etiologies, hypercoagulable states were uncommon, and idiopathic cases were the most common [9,[12][13][14][15][16][17][18][19][20][21]42] . In the series of cases during the last 10 years, various hypercoagulable states are being increasingly described as etiologies of BCS [24][25][26][28][29][30]46,47] .…”

Section: Introductionmentioning

confidence: 99%

“…The majority of patients with BCS present with a chronic course, while only a small number of patients present with acute or fulminant forms [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . BCS is mostly encountered in the adult population and considered uncommon in children; when seen in children, the clinical presentation is similar [13] .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment

Amarapurkar¹,

Punamiya²,

Patel³

2008

WJG

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AIM:To evaluate patterns of obstruction, etiological spectrum and non-surgical treatment in patients with Budd-Chiari syndrome in India. METHODS:Forty-nine consecutive cases of BuddChiari syndrome (BCS) were prospectively evaluated. All patients with refractory ascites or deteriorating liver function were, depending on morphology of inferior vena cava (IVC) and/or hepatic vein (HV) obstruction, triaged for radiological intervention, in addition to anticoagulation therapy. Asymptomatic patients, patients with diuretic-responsive ascites and stable liver function, and patients unwilling for surgical intervention were treated symptomatically with anticoagulation. RESULTS:Mean duration of symptoms was 41.5 ± 11.2 (range = 1-240) mo. HV thrombosis (HVT) was present in 29 (59.1%), IVC thrombosis in eight (16.3%), membranous obstruction of IVC in two (4%) and both IVC-HV thrombosis in 10 (20.4%) cases. Of 35 cases tested for hypercoagulability, 27 (77.1%) were positive for one or more hypercoagulable states. Radiological intervention was technically successful in 37/38 (97.3%): IVC stenting in seven (18.9%), IVC balloon angioplasty in two (5.4%), combined IVC-HV stenting in two (5.4%), HV stenting in 11 (29.7%), transjugular intrahepatic portosystemic shunt (TIPS) in 13 (35.1%) and combined TIPS-IVC stenting in two (5.4%). Complications encountered in follow-up: death in five, re-stenosis of the stent in five (17.1%), hepatic encephalopathy in two and hepatocellular carcinoma in one patient. Of nine patients treated medically, two showed complete resolution of HVT. CONCLUSION:In our series, HVT was the predominant cause of BCS. In the last five years with the availability of sophisticated tests for hypercoagulability, etiologies were defined in 85.7% of cases. Non-surgical management was successful in most cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment

Amarapurkar¹,

Punamiya²,

Patel³

2008

WJG

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The Liver in Pregnancy

Bacq

2011

Schiff's Diseases of the Liver

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Pregnancy complications predict thrombotic events in young women with essential thrombocythemia

et al. 2014

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Although Philadelphia‐negative myeloproliferative neoplasms (MPNs) occur typically in middle to advanced age, any age group may be affected, posing a challenge for their management during pregnancy when they occur in young females. There is a high incidence of thromboembolic events and pregnancy complications in patients with myeloproliferative neoplasms, and a possible relationship between these complications is a matter of concern. The aim of this article was to correlate thrombosis and pregnancy outcome in 158 females with ET experiencing 237 pregnancies. Seven patients had a thrombotic event before their first pregnancy, one of them ended (14.3%) in a miscarriage. Among the 151 patients with no history of thrombosis before they became pregnant, 40 (26.5%) had a miscarriage (P = NS). Eighteen patients (11.4%) developed major thrombotic complications (12 splanchnic vein, 1 cerebral vein, 2 coronary syndromes, and 3 strokes) after at least one pregnancy (4 uneventful and 14 complicated). The occurrence of thrombosis was significantly more frequent (P < 0.001) in patients with a history of pregnancy complications (28%) than in those experiencing a normal pregnancy and delivery (3.7%). Pregnancy complications in women with ET are associated with a higher risk of subsequent thromboses, so pregnant women with this neoplasm who miscarry need to be carefully monitored. Am. J. Hematol. 89:306–309, 2014. © 2013 Wiley Periodicals, Inc.

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Budd-Chiari Syndrome following Pregnancy. Report of 16 Cases, with Roentgenological, Hemodynamic, and Histological Studies of the Hepatic Outflow Tract

Cited by 40 publications

References 0 publications

Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment

Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment

The Liver in Pregnancy

Pregnancy complications predict thrombotic events in young women with essential thrombocythemia

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