Ultrasound study in the diagnosis of primary Budd-Chiari syndrome (obstruction of the inferior vena cava)

Abstract

Primary Budd-Chiari syndrome, obstruction of the hepatic portion of the inferior vena cava (IVC), is a rare disorder, but relatively prevalent in the Far East, northern India and Africa. Ultrasound examination was carried out on 9 patients with primary Budd-Chiari syndrome. There were 5 men and 4 women aged 27-60 years. In all the 9 cases, the diagnosis was confirmed by cavography and liver histology. Moreover, 7 of the 9 subsequently underwent radical operation using a patch graft. Ultrasonic study showed several characteristic findings suggestive of the syndrome, and frequencies of the main findings were as follows: 1) an echogenic obstructing membrane; 22.2%, 2) segmental obstruction of the IVC; 77.8%, 3) occlusion of the major hepatic veins at the juxtacaval portion; 100%, 4) enlarged inferior right hepatic veins; 55.6%, 5) abnormal intrahepatic venous structures and collaterals; 88.9%. Of these findings, 5) was the most prominent and most characteristic in the diagnosis of the syndrome. It is necessary for early detection of this entity to evaluate carefully intrahepatic venous abnormalities and patency of either the IVC or major hepatic veins on ultrasonic examination. The careful examination for Budd-Chiari syndrome should be done in cases with cryptogenic liver cirrhosis, particularly in countries where the prevalence of the syndrome is high.

Primary Antiphospholipid Syndrome Presenting as Budd-Chiari Syndrome

“…Primary BCS is a rare disorder but relatively prevalent in the Far East, Northern India and Africa. 1 The syndrome has been associated with hypercoagulable states neoplasms, trauma, medications, including oral contraceptives, congenital webs in the IVC and/or hepatic veins. 2 There are two major clinical forms of BCS.…”

Síndrome de Budd Chiari: revisión de tema

“…Debe considerarse el diagnóstico del SBC cuando el flujo de las venas hepáticas está ausente o es retrógrado, o cuando las ondas de flujo de estas venas son planas asociadas con un flujo inverso de la vena cava inferior (44). Una serie de 9 casos publicada por Sakugawa y colaboradores demostró que los hallazgos ultrasonográficos más importantes en el diagnóstico del SBC son, en su orden, oclusión de las venas hepáticas y de la porción juxtacaval (100%), presencia de estructuras venosas intrahepáticas anormales y colaterales (89%), obstrucción segmentaria de la vena cava inferior (77,8%), venas hepáticas inferiores derechas prominentes (55,6%) y membrana obstructiva ecogénica (22,2%) (45).…”

Normwerte in der Abdomensonografie - Aorta, Vena cava inferior, Niere

“…Auch für die Diagnose einer (membranösen) Obstruktion der Vena cava inferior hat sich die (Doppler-)Sonografie bewährt [153 -156]. Insbesondere bei Patienten mit kryptogener Leberzirrhose sollte diese im fernen Osten und in Afrika häufiger als in westlichen Ländern vorkommende Erkrankung differenzialdiagnostisch in Erwägung gezogen werden [157]. Dagegen kann eine Agenesie der Vena cava inferior sonografisch meist nicht dargestellt werden.…”