Abstract
BackgroundBudd–Chiari syndrome (BCS) is a rare and potentially life-threatening vascular disease of the liver. There are a few studies on the differences between acute and chronic BCS in clinical and laboratory characteristics, as well as the outcomes, so we designed this research to study the different parameters in acute and chronic BCS. Diagnosis of BCS was made using Doppler ultrasound, magnetic resonance imaging, and venography. Patients with BCS were then divided into chronic and acute groups based on both imaging characteristics and disease duration. Finally, the outcomes, clinical features, and laboratory parameters of acute and chronic BCS were compared.ResultsIn total, 60 patients were included in this study, of whom 28.3% and 71.7% had acute and chronic BCS, respectively. According to clinical features, spontaneous bacterial peritonitis (PR 1.289; 95% CI 1.115–1.489; P = 0.001) and jaundice (PR 1.308; 95% CI 1.148–1.490; P < 0.001) were significantly associated with chronic than acute BCS. According to laboratory parameters, the levels of international normalized ratio (INR) (PR 0.953; 95% CI 0.918–0.989; P = 0.012), blood urea nitrogen (BUN) (PR 0.996; 95% CI 0.993–1.000; P = 0.039), and model for end-stage liver disease (MELD) score (PR 1.024; 95% CI 1.012–1.037; P < 0.001) in chronic group were significantly higher than in the acute BCS. The hospital length of stay (LOS) and mortality rate between the two groups did not differ significantly.ConclusionsThis study showed that the spontaneous bacterial peritonitis, jaundice, increased levels of MELD score, INR, and BUN were significantly associated with the chronic group compared with the acute group. The hospital LOS and mortality rate between the two groups did not differ significantly. Further research is recommended to clarify this issue.
Highlights
Budd–Chiari syndrome (BCS) is a rare and potentially life-threatening vascular disease of the liver
Some studies suggest that clinical presentations have little relationship with the actual duration of BCS [7], acute BCS is usually associated with severe symptoms, poor prognosis, and high mortality, while chronic BCS in most patients has an insidious onset and present with cirrhosis and surface varicose veins
Hepatic venography is recommended if the clinical suspicion of BCS is high, and there are no typical findings in other imaging [8]
Summary
Budd–Chiari syndrome (BCS) is a rare and potentially life-threatening vascular disease of the liver. Patients with BCS were divided into chronic and acute groups based on both imaging characteristics and disease duration. The signs and symptoms of BCS vary, so this diagnosis should be considered in any patient with acute or chronic liver disease [2, 7]. Most physicians differentiate between the acute and chronic forms of the disease based solely on the patient’s history, which makes it difficult to diagnose BCS with insidious presentation. Imaging techniques such as Doppler ultrasound, magnetic resonance imaging (MRI), and computed tomography are necessary to diagnose BCS, as well as to differentiate acute from chronic disease [5]. Hepatic venography is recommended if the clinical suspicion of BCS is high (the presence of hepatomegaly, abdominal pain, and ascites with unknown cause), and there are no typical findings in other imaging [8]
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