Budd-Chiari syndrome is due to thrombosis of
Budd-Chiari syndrome It is caused by obstruction of hepatic venous outflow producing intense congestion of the liver Etiology Polycythemia rubra Vera is the most common etiology In the West, thrombosis of the major hepatic veins is more common In BCS all three major hepatic veins usually are occluded Small hepatic veins that join the retro hepatic IVC, paicularly veins draining the caudate lobe are spared Membranous obstruction of IVC is the most common cause of BCS in Japan, China, India and South Africa Infections causing BCS : Filariaisis, amebic liver abscess, aspergillosis, schistosomiasis, syphilitic gumma and hydatid disease Most common cancer associated with BCS : HCC, RCC, adrenal carcinoma and leimyosarcoma of IVC Clinical features Characterized by triad of Ascites+Hepatomegaly+ abdominal pain (Asha) Abdominal pain, abdominal distension, weakness, anorexia and jaundice Signs are massive ascites, hepatomegaly (with hyperophied Caudate lobe), wasting, abdominal venous distension, splenomegaly, jaundice and edema of thighs, legs and feet Jaundice and abdominal venous distension is more common in hepatic vein occlusion Edema of thighs, legs and feet is seen only in IVC occlusion Striking and progressive weakness occur as a manifestation in acute form but not in cirrhotic forms of BCS Ref: Schwaz's principle of surgery 10th edition Pg no : 1283-1284
Infra renal IVC
Renal pa of IVC
Superior mesenteric vein thrombosis
Hepatic veins
G.I.T