Budd-Chiari syndrome - various etiologies and imagistic findings. A pictorial review

Abstract

Budd Chiari syndrome defines an obstruction of the hepatic venous outflow. Primary causes include pro-coagulant states resulting in venous thrombosis, while secondary Budd Chiari syndrome appears in conditions associated with extrinsic compression of the hepatic veins or tumor invasion. Clinical presentation is greatly varied, from incidentally discovered asymptomatic thrombosis to fulminant liver failure due to hepatic congestion. Abdominal ultrasonography is the key diagnostic tool of Budd Chiari syndrome. This pictorial essay aims to show the ultrasonographic aspect of Budd-Chiari syndrome associated with other medical conditions (abdominal malignancy, hematologic disorders and abdominal surgery).

Budd–Chiari syndrome caused by latent hepatic metastasis from a thymoma

“…Many abdominal tumors, including primary liver cancer and metastatic renal cancer, can cause BCS. However, there have only been a few reports of BCS caused by liver metastases from thoracic tumors, including lung cancer [ 2 ]. In particular, to the best of our knowledge, there are no published reports of secondary BCS caused by thymoma metastasis in the liver.…”

“…Primary BCS is typically caused by thrombosis of the IVC as a result of coagulation abnormalities or membrane-like obstruction. Secondary BCS develops because of extrinsic compression or direct invasion of these veins by primary or metastatic liver cancer [ 2 ]. Imaging tests such as abdominal ultrasound are useful for diagnosis.…”

Unusual Fever, Headache, and Abdominal Pain in a Healthy Woman

“…Clinical manifestations are varied greatly, from incidentally discovered asymptomatic thrombosis to fulminant liver failure. 3 Doppler ultrasound examination is the first-line key diagnostic tool, which is easily available, cost effective, and lacks ionizing radiation. It has a sensitivity and specificity of approximately 85% for the diagnosis of BCS.…”

“…It has a sensitivity and specificity of approximately 85% for the diagnosis of BCS. 3 A contrast-enhanced computed tomography scan is a commonly performed imaging study for BCS. It can help to delineate the vascular abnormality and evaluate the hepatic morphologic changes, as well as mapping the vascular anatomy before surgical interventions.…”

“…It can help to delineate the vascular abnormality and evaluate the hepatic morphologic changes, as well as mapping the vascular anatomy before surgical interventions. 3 …”