Budd-Chiari Syndrome: Analysis of 30 Cases

Abstract

The authors report their experience with 30 adult patients with Budd-Chiari syndrome (BCS), which is a rare and serious disorder, characterized by hepatic outflow obstruction caused by many different conditions. The diagnosis was based on the clinical data, ultrasonography (US), vena cavography and hepatic venography, computed tomography (CT), and liver biopsy. Behçet's disease (BD) was found in 10 patients with BCS as an underlying disease. Two patients used oral contraceptive drugs, 2 had liver tumor hepatocellular carcinoma and liver lymphoma, and 1 patient had chronic lymphocytic leukemia. Despite full investigation, the authors could not find any obvious underlying cause in the other 15 patients. The results suggest that (1) BCS must be considered as a possible complication in patients with Behçet's disease when they have hepatomegaly even if there were no cardinal manifestations of the disease at the time of admission, and BD is the most common etiologic factor in BCS (33%) in Turkey, where the incidence of Behçet's disease is relatively high. (2) Anti-aggregant treatment seems to be effective in many instances. (3) There were space-occupying lesion-like appearances in the liver of 7 cases by CT and US examination in the acute stage, and these disappeared on the follow-up CT and US in 5 patients but continued in 2. BCS should thus be differentiated from other liver lesions. (4) There were other great-vessel involvements in 43% of the cases, mostly venous, but only 1 pulmonary arterial occlusion.

Gastrointestinal Manifestations of Behçet’s Disease

“…In fact, BD is the most common cause of Budd-Chiari syndrome in Turkey [62]. There is a male predominance and the patients are younger than those with Budd-Chiari due to myeloproliferative disorders [63].…”

“…There is a male predominance and the patients are younger than those with Budd-Chiari due to myeloproliferative disorders [63]. It may present with hepatomegaly, ascites, and involvement of other great vessels, mostly venous [62]. Obstruction of the IVC is found in most patients with Budd-Chiari; the latter is due to extension of the thrombus to the ostium of the hepatic veins [63].…”

Behçet’s disease presenting with Budd–Chiari syndrome and intracardial thrombus: a case report

“…The incidence of Behçet’s disease as a cause of Budd–Chiari syndrome is reported to be between 2% and 5.8%. A study by Sahin et al reported Behçet’s disease as the third most common cause of the Budd–Chiari syndrome 8,9…”

Budd-Chiari syndrome: hepatic venous obstruction by an elevated diaphragm

“…Budd-Chiari syndrome can produce a mass lesion in the acute stage due to hemorrhagic necrosis [13,14], and Bayraktar et al [15] reported the disappearance of these lesions on follow-up. In case 2, an irregular cystic lesion with a thick wall was found in the right lobe of the liver, consistent with an area of necrosis.…”