venous lesions have been recognized. The first is thrombosis In contrast with the well-recognized membranous obfollowed by diffuse fibrous obliteration. This lesion affects struction of the inferior vena cava, short-length hepatic the hepatic veins more commonly than the inferior vena cava, vein stenoses are not well-recognized causes of hepatic and, when systematically investigated, an associated hypervenous outflow block. The aim of this study was to ascercoagulable state is usually identified. [2][3][4] The second type of tain the prevalence, causes, manifestations, and outvenous lesion is represented by a short-length stenosis, often come of short-length hepatic vein stenoses. We described as a web or a membrane, located at the terminal performed a retrospective study of patients with shortpart of a vein. This lesion usually affects the inferior vena length hepatic vein stenosis among 86 patients with hecava and is commonly encountered in the absence of an obvipatic venous outflow block who were seen between 1970 ous thrombogenic condition. 5,6 Short-length inferior vena caand 1992. There were 25 patients with short-length heval stenosis has long been thought to be of congenital origin, 5 patic vein stenosis. A thrombogenic condition was idenbut recent evidence suggested that it can be the sequela of a tified in 14 patients (56%). The lesions of the accompaprevious caval thrombosis.6 nying hepatic veins in these patients were variable Short-length hepatic vein stenoses has received little atten-(short-length stenoses, thromboses, or nonspecific tion. The purpose of this report is to describe the prevalence, changes) and similar to that seen in patients without causes, manifestations, and outcome of hepatic venous outshort-length hepatic vein stenosis. In 3 necropsied cases, flow block caused by short-length hepatic vein stenoses. the venous lesions were suggestive of fibrous sequela of prior thromboses. In patients with short-length hepatic PATIENTS AND METHODS vein stenosis, splenomegaly (28% vs. 55%, P õ .05) and hypersplenism were significantly less common; serum From January 1970 to December 1992, 147 patients with hepatictransaminase (P õ .001) and creatinine levels (P õ .02) venous outflow block were admitted to the Liver Units or Surgery were lower, prothrombin was higher (P õ .001), and 5-Departments at Hôpital Beaujon, Hôpital Louis Mourier, and Hôpital de la Salpêtrière. The diagnoses of hepatic venous outflow block were year survival was significantly better (Kaplan-Meier esmade when obstructions of the hepatic veins or inferior vena cava timates: 80% vs. 50%, P õ .05). In patients with hepatic were shown by imaging investigations or when centrilobular distenvenous outflow block, short-length hepatic vein stenosis sion was seen at liver biopsy in the absence of cardiac failure or is a common lesion that appears to be the sequela of pericarditis. 7 Imaging studies of the hepatic veins were reviewed.localized thrombosis. Long-term anticoagulation and Thirty-six cases (24.5%) were excluded because ...
