Budd-Chiari Syndrome in a Patient with Hepatitis C

Abstract EN

Chronic Budd-Chiari syndrome can present with cirrhosis and signs and symptoms similar to those of other chronic liver diseases.

We present a case of Budd-Chiari syndrome discovered during attempted transjugular intrahepatic portosystemic shunting in a patient with decompensated cirrhosis believed to be secondary to hepatitis C.

Although the patient had hepatocellular carcinoma, the Budd-Chiari syndrome was a primary disease due to hepatic venous webs.

Angioplasty was performed in this case, which resolved the patient’s symptoms related to portal hypertension.

Follow-up venography 5 months after angioplasty demonstrated continued patency of the hepatic veins.

A biopsy was obtained in the same setting, which showed centrilobular fibrosis indicating that venous occlusion was indeed the cause of cirrhosis.

It is important to consider a second disease when treating a patient with difficult to manage portal hypertension.