Therapeutic paracentesis can be used for symptomatic treatment of ascites. Paracentesis can be associated with complications such as bacterial peritonitis. The benefits of therapeutic paracentesis must be carefully weighed against its risks. The choice of interventional procedures in the treatment of BCS is based on the type of venous occlusion. Aspiration thrombectomy followed by predilatation with a small diameter catheter. This is associated with a decreased risk of pulmonary embolism and allows the introduction of a thrombolytic catheter for administration of a thrombolytic agent. Endovascular treatment is indicated in patients with thrombosed inferior vena cava. Recanalization of the occluded inferior vena cava results in rapid clinical improvement. Angioplasty is recommended for patients with occluded hepatic vein and patent inferior vena cava. Stenting is preferred if the hepatic vein has a straight course and is of sufficient diameter (≥7 mm). Transjugular Intrahepatic portosystemic shunt (TIPS) is recommended in patients who have developed liver cirrhosis. Transjugular intrahepatic portosystemic shunt (TIPS) decreases porto-systemic gradient hence reducing the risk of variceal bleeding. Liver transplantation is the last rescue treatment when conservative and interventional therapy does not prevent the development of liver cirrhosis and progressive liver failure in chronic BCS. It is generally reserved for patients with fulminant hepatic failure, failure of shunts, or progression of cirrhosis that reduces the life expectancy to 1 year.
Budd-Chiari syndrome surgery
Hepatic hemangioma surgery
Budd-Chiari syndrome medical therapy
Hepatic encephalopathy surgery
Hepatocellular adenoma surgery
Liver mass surgery
Cholangiocarcinoma surgery
Liver mass medical therapy