Budd-Chiari syndrome and other vascular disorders

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The three major vascular disorders of the liver include obstruction to venous outflow (Budd-Chiari syndrome [BCS]), obstruction to venous inflow (portal vein thrombosis [PVT]), and obliteration of the small, terminal hepatic venules (sinusoidal obstruction syndrome [SOS]). A thrombotic diathesis is usually responsible for large vessel thrombosis (BCS and PVT), whereas toxic injury to the endothelial cells causes small vessel disease (SOS). If symptomatic, the clinical presentation is characterized by an acute or subacute increase in portal hypertension, with resulting ascites or variceal bleeding. The goal of treatment is to restore blood flow through the liver. Approaches include systemic anticoagulation or placement of a stent or transjugular intrahepatic portosystemic shunt (TIPS). Over time, provided the liver does not fail, thereby necessitating liver transplantation, collateral circulation will usually develop to bypass the area of obstruction in large vessel thrombosis.

Original languageEnglish (US)
Title of host publicationHandbook of Liver Disease
PublisherElsevier
Pages282-292
Number of pages11
ISBN (Electronic)9780323478823
ISBN (Print)9780323478748
DOIs
StatePublished - Jan 1 2018

Keywords

  • Anticoagulation
  • Ascites
  • Budd-Chiari syndrome
  • Hepatic vein thrombosis
  • Hypercoagulable state
  • Portal vein thrombosis
  • Sinusoidal obstruction syndrome
  • Transjugular intrahepatic portosystemic shunt
  • Venoocclusive disease

ASJC Scopus subject areas

  • Medicine(all)

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