Collateral Pathways in Budd Chiari Syndrome- MDCT Depiction

Usha Chauhan ,Goel ,M K Singh ,N Arunai Nambi Raj ,Nirmal Kumar Jain ,Sunil K Puri

doi:10.4172/2472-1891.100025

Abstract

Budd Chiari syndrome (BCS) is a condition arising from hepatic venous outflow tract obstruction (HVOTO) arising at the level of hepatic veins, inferior vena cava, right atrium or a combination of these. It can be classified as primary or secondary depending upon the underlying pathophysiology. Regardless of the cause of HVOTO, there is lack/complete absence of hepatic venous drainage leading to constellation of symptoms pertaining to portal hypertension with radiologically visible intrahepatic and extrahepatic porto-systemic collaterals. The presence of these collateral systems provide imaging diagnostic clue in chronic cases with cirrhosis labelled as chronic liver disease and thereby establishing the primary cause of cirrhosis to be BCS. Current essay aims to provide in depth knowledge of collateral pathways of BCS.

Highlights

Budd Chiari syndrome (BCS) is a condition arising from hepatic venous outflow tract obstruction (HVOTO) arising at the level of hepatic veins, inferior vena cava, right atrium or a combination of these
The presence of these collateral systems provide imaging diagnostic clue in chronic cases with cirrhosis labelled as chronic liver disease and thereby establishing the primary cause of cirrhosis to be BCS
We present the current essay from the case of a 25 year old female patient diagnosed as chronic liver disease (CLD) presenting with pain abdomen, ascites and deranged liver functions with a history of single episode of upper GI bleed

Summary

Introduction

Budd Chiari syndrome (BCS) is a condition arising from hepatic venous outflow tract obstruction (HVOTO) arising at the level of hepatic veins, inferior vena cava, right atrium or a combination of these. The causes of primary BCS in western countries include the hepatic venous thrombosis/IVC thrombosis due to systemic disease in contrast to membranous or segmental obstruction of IVC in the Asian countries. The presence of these collateral systems provide imaging diagnostic clue in chronic cases with cirrhosis labelled as chronic liver disease and thereby establishing the primary cause of cirrhosis to be BCS.

Results

Conclusion