Percutaneous hepatic vein reconstruction for Budd-Chiari syndrome.

Abstract

Short hepatic vein or inferior vena cava(IVC) occlusionsassociated with Budd-Chiari syndromeare usually treated by balloon dilatation and vas cular stent placement. Long-segment chronic occlusionscan make such revascularization techniques more challenging. We describe the transhepatic use of an angled transjugular liver biopsy cannula and a flexible tip needle for creating a tract between a right hepatic vein remnant and the IVC to restore hepatic vein outflow in a patient with Budd-Chiari syndrome. Rapid resolution of the patient's asciteswas associatedwith incarcerationof an umbilicalhernia. Subject and MethodsA 24-year-old woman with a 7-year histoty of pctlycythemiavera presentedwith abdominal disten

Pericardiectomy causing abdominal hernia incarceration

“…However, reduction of chronic ascites may be complicated by hernia incarceration as the fluid buffer around the hernial orifice dissipates. Incarceration of umbilical hernias associated with ascites were described after large volume paracentesis [3,4] diuretic therapy [3][4][5], peritoneovenous shunting [4,6] hepatic vein stenting [7] and transjugular intrahepatic portosystemic shunting [8]. Here, we describe the first report of abdominal hernia incarceration after pericardiectomy.…”

Incarceration of umbilical hernia following transjugular intrahepatic portosystemic shunt for the treatment of ascites

“…5,7 We previously reported incarceration of umbilical hernia during resolution of ascites in a patient who underwent hepatic vein stenting for Budd-Chiari syndrome. 8 The common feature in all of these patients was improvement or resolution of ascites following therapy. This is a report of umbilical hernia incarceration following TIPS.…”

Budd-Chiari syndrome: Diagnosis with three-dimensional contrast-enhanced magnetic resonance angiography

“…3D CE MRA could distinguish extravascular compression from intravascular thrombosis, detect liver abnormalities and evaluate the extent of the disease. By means of only one examination, 3D CE MRA provided all these crucial information for accurate diagnosis of BCS and for possible surgical or interventional managements, such as porto-caval shunt, liver transplantation, transjugular intrahepatic porto-systemic shunt (TIPSS), percutaneous transluminal angioplasty (PTA) and stent placement [22][23][24][25][26][27] . Among 13 patients of secondary BCS, tumor thrombosis, external compression and direct invasion of hepatic veins and/or IVC by tumors were the main causes of this disease.…”