Budd chiari syndrome

  • Type III Budd Chiari syndrome refers to Obstruction of the small centrilobular venules
  • Intraluminal echogenicity of hepatic vein, Thickened walls of hepatic vein & Stenosis and proximal dilatation of the hepatic veins are sonological features of Budd Chiari syndrome
  • The INITIAL investigation of choice in acute budd chiari syndrome is USG abdomen
  • A specific diagnostic criteria for Budd Chiari syndrome is Intrahepatic collaterals
  • Pseudo Portal doppler signal (continuous flow) in the hepatic vein in the setting of Budd chiari syndrome indicates Partial IVC obstruction
  • Budd chiari syndrome can be caused by Thrombosis of hepatic veins, Polycythemia , Drinking Herbal tea
  • Budd-chiari syndrome is Associated with coagulopathy
  • Cirrhosis may occur in Budd-chiari syndrome
  • Budd- chiari syndrome is characterised by Hepatomegaly
  • Budd-chiari syndrome is most commonly due to Hepatic vein obstruction
Hepatic vein thrombosis is associated with in decreasing order of frequency:
  1. Polycythemia vera 
  2. Pregnancy
  3. Postpartum state
  4. Use of oral contraceptives
  5. Paroxysmal nocturnal hemoglobinuria (PNH) 
  6. lntraabdominal cancers, particularly hepatocellular carcinoma
  • Most common cause of Budd Chiari syndrome is Thrombosis of hepatic veins
  • In Budd Chiari syndrome, the site of venous thrombosis is Hepatic veins
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