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Liver Int 2022 May 20. Epub 2022 May 20.

Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi'an International Medical Center Hospital, Northwest University, Xi'an, China.

Liver diseases are major causes of illness and death worldwide. In China, liver diseases, primarily viral hepatitis, affect approximately 300 million people, thus having a major impact on the global burden of liver diseases. Portal hypertension is the most severe complications of chronic liver diseases, including ascites, hepatic encephalopathy and bleeding from gastroesophageal varices. Read More

AJR Am J Roentgenol 2022 May 18. Epub 2022 May 18.

Dotter Department of Interventional Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, USA.

The most challenging and time-consuming step of transjugular intrahepatic portosystemic shunt (TIPS) procedures is obtaining appropriate portal vein access. Given the lack of real-time direct target visualization, conventional fluoroscopic guidance requires multiple passes, contributing to complications. In comparison, intravascular ultrasound (IVUS) guidance during TIPS procedures provides direct visualization of hepatic structures and real-time guidance for portal vein puncture. Read More

J Clin Med Res 2022 Apr 30;14(4):147-157. Epub 2022 Apr 30.

Department of Hepato-Biliary and Liver Transplantation Surgery, Paul Brousse University Hospital, Paris-Saclay University, 94800 Villejuif, France.

Background: Budd-Chiari syndrome (BCS) is an eponym that includes a group of conditions characterized by partial or complete hepatic venous tract outflow obstruction, and the site of obstruction may involve one or more hepatic veins, inferior vena cava, or the right atrium. The classification of BCS is based on etiology, site of obstruction, and duration. Its etiology is very heterogeneous; in particular, hepatic vein thrombosis is the most common type of obstruction and myeloproliferative disorder, the most common thrombophilic disorder, in the West. Read More

Clin Gastroenterol Hepatol 2022 May 12. Epub 2022 May 12.

Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address:

Aims: Patients with Budd-Chiari syndrome (BCS) have an elevated risk of overall and liver-specific mortality, but this has not been quantified on a population level nor compared against a matched general population cohort.

Methods: We identified all patients in Sweden with a recorded diagnosis of BCS in the Swedish National Patient Register between 1987 and 2016. Patients with BCS were matched for age, sex and municipality at baseline with up to 10 reference individuals from the general population. Read More

Cir Esp (Engl Ed) 2022 May 9. Epub 2022 May 9.

Servicio de Cirugía General y del Aparato Digestivo y Trasplantes, Complejo Regional Universitario de Málaga, Spain.

Complete liver mobilization for major resections sometimes causes liver tilting due to the release of the suspensory elements of the liver. Rarely this may take to a liver abnormal position with acute obstruction to venous flow at the suprahepatic level (Budd-Chiari syndrome). To avoid this complication, techniques such as post-operative stent implantation have been described. Read More

Clin Gastroenterol Hepatol 2022 May 6. Epub 2022 May 6.

Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Liver Study Group, Medical University of Vienna, Vienna, Austria.

Background And Aims: Direct oral anticoagulants (DOACs) may simplify management of Budd-Chiari Syndrome (BCS). Here we report our experience with off-label use of DOACs for anticoagulation in BCS.

Methods: Safety of DOAC vs. Read More

J Radiol Case Rep 2022 Apr 1;16(4):17-23. Epub 2022 Apr 1.

Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India.

Massive ovarian edema is an uncommon benign condition affecting young females predominantly those in the child bearing age group and preadolescent girls. Its clinical and radiologic overlap with ovarian neoplasms and torsion which require surgical intervention makes it imperative for the radiologist to consider this entity preoperatively as preserving fertility is vital in this young age group. We report a case of massive ovarian edema, a rare presentation in a patient with inferior vena cava web and consequent Budd Chiari Syndrome, an association previously unreported in literature. Read More

Am J Clin Exp Urol 2022 15;10(2):123-128. Epub 2022 Apr 15.

Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital Miami, FL, USA.

Renal cell carcinoma (RCC) with inferior vena cava (IVC) and right atrium (RA) tumor thrombus (TT) is a rare occurrence and its resection is surgical challenge. Management becomes even more difficult when the TT causes hepatic vein obstruction and leads to Budd-Chiari syndrome. We report a case of 68-year-old male with right RCC with IVC and RA TT with associated Budd-Chiari syndrome. Read More

Indian J Crit Care Med 2022 Mar;26(3):387-389

Department of General Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.

We report a case of fulminant hepatic failure due to the Budd-Chiari syndrome following preservation with a tropical fever. A young lady came with fever, altered mental status, jaundice, and renal failure. Following tropical workup, it was diagnosed as a case of leptospirosis (WHO Faine's criteria) with multi-organ dysfunction. Read More

Vasc Med 2022 Apr 27:1358863X221087251. Epub 2022 Apr 27.

Department of Medicine, Section of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.

Blood Adv 2022 Apr 19. Epub 2022 Apr 19.

University of Malta, Msida, Malta.

Heparins and vitamin K antagonists are the mainstay of treatment for splanchnic vein thrombosis (SVT). Rivaroxaban is a potential alternative, but data to support its use are limited. We aimed to evaluate the safety and efficacy of rivaroxaban for the treatment of acute SVT. Read More

Front Surg 2022 1;9:747671. Epub 2022 Apr 1.

Department of Radiology and Imaging, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.

Splanchnic vein thrombosis is an unusual manifestation of venous thromboembolism and includes portal vein thrombosis, mesenteric veins thrombosis, splenic vein thrombosis, and the Budd-Chiari syndrome. The most common risk factors include hematologic and autoimmune disorders, hormonal therapy, liver cirrhosis, solid abdominal cancer, recent abdominal surgery, and abdominal infections or inflammatory conditions, such as pancreatitis. Splanchnic vein thrombosis in acute pancreatitis is most commonly associated with the severe form of the disease and pancreatic necrosis. Read More

J Gastrointestin Liver Dis 2022 03 20;31(1):146-147. Epub 2022 Mar 20.

Division of Gastroenterology and Hepatology, Allegheny Health Network, Pittsburgh, PA, USA.

Hepatol Int 2022 Mar 17. Epub 2022 Mar 17.

Department of Gastroenterology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, 400012, India.

Background And Aims: Budd Chiari syndrome (BCS) commonly affects adolescents and adults. With improved survival, important quality-of-life parameters such as sexual life and fertility become more relevant. This study was aimed to assess the gonadal function in male patients with BCS and the effect of treatment on gonadal function. Read More

Liver Int 2022 Mar 15. Epub 2022 Mar 15.

Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.

Sci Rep 2022 03 10;12(1):3903. Epub 2022 Mar 10.

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jian She Road, Zhengzhou, 450052, China.

Recanalization of inferior vena cava (IVC) with complete obstruction, old thrombosis or long segmental stenosis/obstruction (complicated IVC) via transfemoral access may fail in patients with Budd-Chiari syndrome (BCS). In this study, 34 consecutive patients with BCS underwent recanalization of complicated IVC occlusion via jugular-femoral venous (JFV) route establishment. BCS with complicated IVC was detected by reviewing preoperative color Doppler ultrasonography or computed tomography (CT) venography, and confirmed by intraoperative venography. Read More

Zhonghua Wai Ke Za Zhi 2022 Apr;60(4):329-336

Budd-Chiari syndrome (B-CS) is a complicated hepatic vascular disease caused by hepatic venous outflow obstruction.There are significant differences in the pathogenesis and treatment of B-CS between China and Western countries.Given the characteristics of B-CS in our country,Budd-Chiari Syndrome and Hepatic Vascular Diseases Professional Committee of Chinese Research Hospital Association organizes domestic experts in this field to formulate the "Chinese multidisciplinary collaborative expert consensus for the diagnosis and treatment of Budd-Chiari syndrome（2021 version）". Read More

Int J Gen Med 2022 2;15:2389-2396. Epub 2022 Mar 2.

Department of Radiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

Objective: This study aimed to analyze the clinical features and computed tomography (CT) manifestations of hepatic sinusoidal obstruction syndrome (HSOS) induced by Gynura segetum, a Chinese herbal medicine, so as to improve the clinical understanding and diagnosis of the disease.

Methods: Relevant clinical and laboratory parameters and CT imaging data of 20 patients with HSOS confirmed by liver biopsy were retrospectively analyzed and compared with 16 patients with Budd-Chiari syndrome (BCS).

Results: Levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and glutamyl transpeptidase increased significantly (p < 0. Read More

J Vasc Interv Radiol 2022 05 24;33(5):617. Epub 2022 Feb 24.

Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, India.

J Vasc Interv Radiol 2022 05 22;33(5):616-617. Epub 2022 Feb 22.

Centro di Riferimento Regionale per le Malattie Rare, Sindrome di Budd-Chiari e Teleangectasia Emorragica Ereditaria, Medicina Interna 1, ARNAS Civico - Di Cristina - Benfratelli, Piazzale Leotta 4, Palermo 90100, Italy.

Gastroenterology 2022 Feb 8. Epub 2022 Feb 8.

Department of Hepatology, Toulouse University Hospital, Toulouse 3 University, France.

Indian J Radiol Imaging 2021 Oct 30;31(4):858-866. Epub 2021 Nov 30.

Department of Hepatology, Christian Medical College, Vellore, Tamil Nadu, India.

 The aim of the study is to evaluate the technical and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) performed with additional transabdominal ultrasound guidance.  Patients who underwent TIPS between January 2004 to January 2020 in our center were studied. Technical, hemodynamic, angiographic, and clinical outcome were recorded up to 1 year of follow-up. Read More

World J Gastroenterol 2022 Jan;28(1):23-46

Department of Pathology, School of Medicine, University of Zagreb, Zagreb 10000, Croatia.

The stable gastric pentadecapeptide BPC 157 counteracts various venous occlusion-induced syndromes. Summarized are all these arguments, in the Robert's cytoprotection concept, to substantiate the resolution of different major vessel occlusion disturbances, in particular ischemia-reperfusion injury following the Pringle maneuver and Budd-Chiari syndrome, which was obtained by BPC 157 therapy. Conceptually, there is a new point, namely, endothelium maintenance to epithelium maintenance (the recruitment of collateral blood vessels to compensate for vessel occlusion and reestablish blood flow or bypass the occluded or ruptured vessel). Read More

Indian J Hematol Blood Transfus 2022 Jan 18;38(1):169-172. Epub 2021 Jun 18.

Department of Gastroenterology, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh, 160012 India.

The role of polymorphism in venous thrombosis is unclear. PAI-1 4G/4G genotype is associated with elevated levels of PAI-1 resulting in a hypofibrinolytic state and hence increased thrombotic risk. In this study, we assessed the role of promoter polymorphism in adult patients with splanchnic vein thrombosis. Read More

Expert Rev Gastroenterol Hepatol 2022 Mar 17;16(3):279-287. Epub 2022 Feb 17.

State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, The First Clinical Medical College of Xinjiang Medical University, Urumqi, China.

Background: This study was designed to investigate the techniques of hepatic venous outflow reconstruction and the management of its complications using ex vivo liver resection and autotransplantation (ELRA).

Methods: Being a retrospective case series covering 84 patients who underwent hepatic venous outflow reconstruction during ELRA from January 2016 to October 2020, 11 cases of postoperative hepatic venous outflow obstruction (HVOO), whose surgery details were described and survival rates analyzed.

Results: A total of the 84 alveolar (AE) series was no intraoperative death. Read More

Ann Med Surg (Lond) 2022 Jan 1;73:103218. Epub 2022 Jan 1.

Radiology Department, French Medical Institute for Mothers and Children (FMIC), Jamal mena, Kabul, Afghanistan.

Introduction: Budd-Chiari syndrome is a rare disease characterized by hepatic venous flow obstruction. The obstruction may be thrombotic or non-thrombotic anywhere along the venous course from the hepatic venules to the inferior vena cava (IVC) junction to the right atrium. In clinical practice, cases can be misdiagnosed, particularly in regions where resources are limited, unless the clinician pays special attention to such diagnosis. Read More

J Clin Exp Hepatol 2022 Jan-Feb;12(1):29-36. Epub 2021 Apr 24.

Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, 1, Press Enclave Road, Saket, New Delhi, 110017, India.

Background: Natural portosystemic shunt ligation practices in liver transplant vary widely across transplant centres and are frequently undertaken to prevent the serious consequence of portal steal phenomenon. No concrete indications have so far been convincingly identified for their management in living donor liver transplant.

Methods: We retrospectively studied the outcome of 89 cirrhotic patients who either did (n = 63) or did not (n = 25) undergo shunt ligation during living donor liver transplantation between 2017 and 2020. Read More

Arch Argent Pediatr 2022 02 21;120(1):S9-S18. Epub 2021 Dec 21.

Portal hypertension is a complex syndrome caused by increased resistance to the splachnic venous flow at the portal vein level, with a hyperdynamic systemic circulation characterized by peripheral vasodilation and high cardiac output. Portal flow can be obstructed at prehepatic (¨normal liver¨), intrahepatic (as in cirrhosis), or post-hepatic level (as in Budd-Chiari syndrome). In pediatric patients, prehepatic and intrahepatic causes are almost equally distributed (nearly 50% each). Read More

Eur J Case Rep Intern Med 2021 17;8(12):003081. Epub 2021 Dec 17.

Internal Medicine, Rochester General Hospital, Rochester, New York, USA.

Budd-Chiari syndrome (BCS) results from an occlusion of the hepatic venous flow which in turn leads to portal hypertension causing ascites and other signs of liver dysfunction. Here, we present the case of a 43-year-old woman with recurrent ascites who was found to have BCS secondary to an inferior vena cava thrombosis extending into the hepatic veins. Although she had a normal platelet count on admission, additional laboratory investigations revealed an MPL mutation. Read More

Cardiovasc Intervent Radiol 2022 May 12;45(5):542-549. Epub 2022 Jan 12.

Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Germany.

Purpose: This study compares the safety and efficacy of the ePTFE-covered self-expansible nitinol stent (VIATORR® Controlled Expansion, Gore, Flagstaff, USA) with the ePTFE-covered, balloon-expandable, metallic stent (BeGraft peripheral, Bentley, Hechingen, Germany) for the creation of the transjugular intrahepatic portosystemic shunt (TIPS).

Material And Methods: From September 2016 to December 2020, 72 consecutive patients receiving TIPS for acute variceal bleeding (rescue and early TIPS, n = 15) or for prophylaxis of variceal rebleeding (n = 57) were enrolled. The main contraindications were patients with vascular liver disease (portal vein thrombosis and Budd-Chiari syndrome). Read More