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{{Budd-Chiari syndrome}}
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==Overview==
==Overview==
[[Liver biopsy]] and [[histology]] is a useful investigation if [[liver transplantation]] is being considered as it helps identify the degree of [[Hepatocellular Disease|hepatocellular damage]] and the degree of [[fibrosis]]. Findings on [[liver biopsy]] suggestive of Budd Chiari include high grade [[venous]] [[congestion]], centrilobular [[Atrophy|liver cell atrophy]], [[thrombi]] within the terminal [[Venules|hepatic venules]], [[Fibrosis|massive fibrosis]] in [[fulminant hepatic failure]]. [[Invasive]] [[Imaging|imaging methods]] are used to identify [[obstruction]] of the [[Venous|venous outflow]]. [[Angiography]] of the [[inferior vena cava]] and [[hepatic veins]] can be used together with interventional [[therapeutic]] procedures to restore patency of the [[vessels]].


==Other Diagnostic Studies==
==Other Diagnostic Studies==
Liver Biopsy and Histology is a useful investigation if liver transplantation is being considered as it helps identify the degree of hepatocellular damage and the degree of fibrosis. Findings on  liver biopsy suggestive of Budd Chiari include venous congestion high grade, centrilobular liver cell atrophy, thrombi within the terminal hepatic venules, massive fibrosis in fulminant hepatic failure.Invasive imaging methods are used to identify obstruction of the venous outflow.Angiography of the inferior vena cava and hepatic veins can be used together with interventional therapeutic procedures to restore patency of the vessels.
Other [[Diagnostic|diagnostic studies]] of Budd-Chiari syndrome are as follows:<ref name="pmid28922103">{{cite journal |vauthors=Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A |title=Budd-Chiari Syndrome |journal=Prague Med Rep |volume=118 |issue=2-3 |pages=69–80 |year=2017 |pmid=28922103 |doi=10.14712/23362936.2017.6 |url=}}</ref><ref name="pmid26494427">{{cite journal |vauthors=Goel RM, Johnston EL, Patel KV, Wong T |title=Budd-Chiari syndrome: investigation, treatment and outcomes |journal=Postgrad Med J |volume=91 |issue=1082 |pages=692–7 |year=2015 |pmid=26494427 |doi=10.1136/postgradmedj-2015-133402 |url=}}</ref>
 
===Liver biopsy and histology===
===Liver Biopsy and Histology===
*[[Liver biopsy]] and [[histology]] may be helpful in the [[diagnosis]] of Budd-Chiari syndrome.  
*Liver Biopsy and Histology may be helpful in the diagnosis of Budd-Chiari syndrome.  
*[[Liver biopsy]] and [[histology]] is a useful investigation if [[liver transplantation]] is being considered as it helps identify the degree of [[Hepatocellular Disease|hepatocellular damage]] and the [[Fibrosis|degree of fibrosis]]. Findings on [[liver biopsy]] suggestive of Budd Chiari include:
*Liver Biopsy and Histology is a useful investigation if liver transplantation is being considered as it helps identify the degree of hepatocellular damage and the degree of fibrosis. Findings on liver biopsy suggestive of Budd Chiari include:
**High grade [[venous]] [[congestion]]
**Venous congestion high grade
**Centrilobular liver cell [[atrophy]]
**centrilobular liver cell atrophy
**[[Thrombi]] within the terminal [[hepatic]] [[venules]]
**thrombi within the terminal hepatic venules
**[[Fibrosis|Massive fibrosis]] in [[fulminant hepatic failure]]
**Massive fibrosis in fulminant hepatic failure
===Angiography and venography===
===Angiography and venography===
*Angiography and venography may be helpful in the diagnosis of Budd-Chiari syndrome.
*[[Angiography]] and [[venography]] may be helpful in the [[diagnosis]] of [[Budd-Chiari syndrome]].
*Invasive imaging methods are used to identify obstruction of the venous outflow.  
*[[Invasive]] [[Imaging|imaging methods]] are used to identify [[obstruction]] of the [[Venous|venous outflow]].  
*Angiography of the inferior venacava and hepatic veins can be used together with interventional therapeutic procedures to restore patency of the vessels.
*[[Angiography]] of the [[inferior vena cava]] and [[hepatic veins]] can be used together with interventional [[therapeutic]] procedures to restore patency of the [[vessels]].
*Findings on angiography suggestive of Budd Chiari include:
*Findings on [[angiography]] suggestive of Budd Chiari include:
**hepatosplenomegaly
**[[Hepatosplenomegaly]]
**stretched intrahepatic arteries  
**Stretched intra-[[hepatic]] [[arteries]]
**Dilated hepatic arteries in patients with chronic disease, arteriovenous shunting in patients with chronic disease mottled appearance of liver
**Dilated hepatic [[arteries]] in patients with [[chronic]] [[disease]], [[Shunting|arteriovenous shunting]] in patients with [[chronic disease]] mottled appearance of [[liver]]
**sinusoidal contrast accumulation seen as large lakes is occasionally seen.
**[[Sinusoidal]] [[contrast]] accumulation seen as large lakes is occasionally seen.
**cul-de-sac phenomenon: contrast material may progress slowly through the liver, often with outflow through the portal vein, which is referred to as the cul-de-sac phenomenon.
**Cul-de-sac phenomenon consists of [[contrast]] material may progress slowly through the [[liver]], often with outflow through the [[portal vein]].
**Portography shows central hepatic enhancement of the liver with normal hepatopetal flow.
**[[Portography]] shows central [[hepatic]] enhancement of the [[liver]] with normal hepatoportal flow.
**Splenoportographic findings vary according to the duration of disease. In early stages of BCS, flow within the portal vein is centripetal, associated with delayed emptying and stretched portal vein radicles. In later stages of BCS, portal venous flow  is reversed, and the splenic and portal veins may not fill.
**Splenoportographic findings vary according to the duration of disease. In early stages of BCS, flow within the [[portal vein]] is centripetal, associated with delayed emptying and stretched [[portal vein]] radicles. In later stages of BCS, [[Portal vein|portal venous]] flow  is reversed, and the [[splenic]] and [[Portal vein|portal veins]] may not fill.


==References==
==References==

Latest revision as of 20:23, 1 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Overview

Liver biopsy and histology is a useful investigation if liver transplantation is being considered as it helps identify the degree of hepatocellular damage and the degree of fibrosis. Findings on liver biopsy suggestive of Budd Chiari include high grade venous congestion, centrilobular liver cell atrophy, thrombi within the terminal hepatic venules, massive fibrosis in fulminant hepatic failure. Invasive imaging methods are used to identify obstruction of the venous outflow. Angiography of the inferior vena cava and hepatic veins can be used together with interventional therapeutic procedures to restore patency of the vessels.

Other Diagnostic Studies

Other diagnostic studies of Budd-Chiari syndrome are as follows:[1][2]

Liver biopsy and histology

Angiography and venography

References

  1. Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A (2017). "Budd-Chiari Syndrome". Prague Med Rep. 118 (2–3): 69–80. doi:10.14712/23362936.2017.6. PMID 28922103.
  2. Goel RM, Johnston EL, Patel KV, Wong T (2015). "Budd-Chiari syndrome: investigation, treatment and outcomes". Postgrad Med J. 91 (1082): 692–7. doi:10.1136/postgradmedj-2015-133402. PMID 26494427.

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