Acute iatrogenic Budd-Chiari syndrome following hepatectomy for hepatolithiasis: A report of two cases

Abstract

Budd-Chiari syndrome (BCS) is defined as hepatic venous outflow obstruction at any level from the small hepatic veins to the junction of the inferior vena cava (IVC) and the right atrium, regardless of the cause of obstruction. We present two cases of acute iatrogenic BCS and our clinical management of these cases. The first case was a 43-year-old woman who developed acute BCS following the implantation of an IVC stent for the correction of stenosis in the IVC after hepatectomy for hepatolithiasis. The second case was a 61-year-old woman with complete obstruction of the outflow of hepatic veins during bilateral hepatectomy for hepatolithiasis. Acute iatrogenic BCS should be considered a rare complication following hepatectomy for hepatolithiasis. Awareness of potential hepatic outflow obstructions and timely management are critical to avoid poor outcomes when performing hepatectomy for hepatolithiasis.

Acute Budd-Chiari syndrome during hepatic vein catheterization

“…Additionally, 1 case series described 3 adult patients with BCS who experienced acute iatrogenic IVC thrombi, following a failure of re-establish patency of the occluded IVC, were successfully treated with agitation thrombolysis [13] . Two cases of iatrogenic BCS following hepatectomy for hepatolithiasis had been described [14] . A few cases have been reported of acute BCS following hepatectomy due to torsion of the remnant liver causing compression of the IVC or kinking of the left hepatic vein [15 , 16] .…”

Colon Perforation and Budd-Chiari Syndrome in Behçet’s Disease

“…Budd-Chiari syndrome (BCS) is characterized by obstruction of hepatic venous flow (due to any cause) from the level of hepatic venules and large hepatic veins through the inferior vena cava and the right atrium [ 20 – 23 ]. The most common causes are hypercoagulation states [ 21 ]. The frequency of vascular involvement (superficial and deep venous thrombosis, arterial aneurysms, and occlusions) in BD ranges from 7% to 29% [ 24 ].…”