Yonghua Bi, Xiaoyan Zhu, Mengfei Yi, Xinwei Han, Jianzhuang Ren
OBJECTIVE: We aimed to analyze the pathological changes of the occlusive area of the inferior vena cava (IVC) in patients with Budd-Chiari syndrome (BCS) and to explore its possible etiology and pathogenesis. METHODS: Color Doppler ultrasound and IVC angiography were used to evaluate causes of occlusion. Clamp biopsies were performed in the occlusive area of the IVC in 31 patients with BCS, and the specimens were examined pathologically. Clinical data were collected retrospectively...
July 2020: Journal of International Medical Research
A Sharma, S N Keshava, A Eapen, E Elias, C E Eapen
Budd-Chiari syndrome (BCS) is an uncommon condition, caused by obstruction to hepatic venous outflow. It is largely underdiagnosed, and a high index of suspicion is required for any patient with unexplained portal hypertension. The understanding of its etiology and pathology is improving with advances in diagnostic techniques. Recent studies reported an identifiable etiology in > 80% of cases. Myeloproliferative neoplasm (MPN) is the most common etiology, and genetic studies help in diagnosing latent MPN...
July 20, 2020: Digestive Diseases and Sciences
Giovanna Ferraioli, Richard G Barr
Several guidelines have indicated that liver stiffness (LS) assessed by means of shear wave elastography (SWE) can safely replace liver biopsy in several clinical scenarios, particularly in patients with chronic viral hepatitis. However, an increase of LS may be due to some other clinical conditions not related to fibrosis, such as liver inflammation, acute hepatitis, obstructive cholestasis, liver congestion, infiltrative liver diseases. This review analyzes the role that SWE can play in cases of liver congestion due to right-sided heart failure, congenital heart diseases or valvular diseases...
June 28, 2020: World Journal of Gastroenterology: WJG
Amit Tanwar, Gaurav K Gupta, Virender Chauhan, Deepak Sharma, Mukesh K Jain, Hemendra Bhardwaj, Ashok Jhajharia, Sandeep Nijhawan
Introduction: Celiac disease (CD) has been linked to portal hypertension (PHT) of varied etiology, but the causality association has never been proved. We aim to study the prevalence of CD in patients of PHT of different etiology. Methods: A prospective observational study was conducted from June 2017 to December 2018 involving all the cases of PHT of varied etiology. Consecutive patients of PHT with chronic liver disease (CLD) of defined etiology like ethanol, viral hepatitis (B or C), Budd-Chiari syndrome (BCS), autoimmune-related cirrhosis, and cryptogenic CLD (cCLD) (group A) and those with noncirrhotic PHT (NCPHT), which included noncirrhotic portal fibrosis (NCPF) and extrahepatic portal vein obstruction (EHPVO) (group B), were screened for CD by IgA anti-tTG antibody followed by duodenal biopsy in serology-positive patients...
July 2020: Journal of Clinical and Experimental Hepatology
Lamia Y K Haque, Joseph K Lim
Budd-Chiari syndrome (BCS), or hepatic venous outflow obstruction, is a rare cause of liver disease that should not be missed. Variable clinical presentation among patients with BCS necessitates a high index of suspicion to avoid missing this life-threatening diagnosis. BCS is characterized as primary or secondary, depending on etiology of venous obstruction. Most patients with primary BCS have several contributing risk factors leading to a prothrombotic state. A multidisciplinary stepwise approach is integral in treating BCS...
August 2020: Clinics in Liver Disease
Wei Zhang, Chunyan Peng, Song Zhang, Shuling Huang, Shanshan Shen, Guifang Xu, Feng Zhang, Jiangqiang Xiao, Ming Zhang, Yuzheng Zhuge, Lei Wang, Xiaoping Zou, Ying Lv
BACKGROUND AND AIMS: EUS-guided portal pressure gradient (PPG) measurement is a novel method to evaluate portal hypertension severity. In this study, we determined the consistency between EUS-PPG and hepatic venous pressure gradient (HVPG) measurements in patients with acute or sub-acute portal hypertension. METHODS: Twelve patients were prospectively enrolled. EUS-guided PPG measurements were performed using a 22-gauge fine-needle aspiration (FNA) needle and a central venous pressure measurement monitor...
June 29, 2020: Gastrointestinal Endoscopy
Rajeev Redkar, Vinod Raj, Shruti Tewari, Rahul Sharma, Shirin Joshi
INTRODUCTION: Budd-Chiari syndrome (BCS) is a rare condition affecting children. It is characterized by occlusion of venous outflow from liver at the level of hepatic veins (HV) or inferior vena cava (IVC). The management of BCS in children revolves around forming new collaterals for venous outflow or by elimination of blockage in the venous outflow tracts. These can be achieved by balloon venoplasty (BV), transjugular intrahepatic portosystemic shunting (TIPSS) or open shunt surgeries...
May 23, 2020: Journal of Pediatric Surgery
K M Wcislo, C E Hall, N Abbassi-Ghadi
Acute Budd-Chiari syndrome is a rare condition characterised by obstruction of hepatic venous outflow. We describe the case of a 52-year-old man, with a congenital Morgagni diaphragmatic hernia, who presented with acute onset abdominal pain, shortness of breath, lactic acidosis, hyperbilirubinaemia and transaminasaemia. Computed tomography revealed strangulation of the diaphragmatic hernia and extrinsic compression of the inferior vena cava from the herniated viscera. Emergency surgery was carried out to repair the hernia with a biosynthetic mesh, with complete resolution of the Budd-Chiari syndrome...
June 15, 2020: Annals of the Royal College of Surgeons of England
Bai-Guo Xu, Jing Liang, Ke-Feng Jia, Tao Han
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) often involves the liver, and belongs to abnormal blood vessel disease. The etiology of Budd-Chiari syndrome (BCS) is not clear, but congenital vascular dysplasia is considered to be one of the causes. Liver cirrhosis due to hepatic hereditary hemorrhagic telangiectasia concomitant with BCS has not been reported. Here, we report a case of cirrhosis with hepatic hereditary hemorrhagic telangiectasia (HHHT) and BCS. CASE PRESENTATION: A 58-year-old woman with hepatic hereditary hemorrhagic telangiectasia showed decompensated liver cirrhosis, and abdominal imaging revealed Budd-Chiari syndrome...
June 3, 2020: BMC Gastroenterology
Huawei Li, Xi Zhang, Hao Xu, Maoheng Zu, Ning Wei, Hongtao Liu, Jinchang Xiao, Bin Shen, Qianxin Huang, Qingqiao Zhang
OBJECTIVE: Interventional treatment is the main therapy for Budd-Chiari syndrome (BCS) with hepatic vein obstruction. The aim of this study was to investigate the long-term outcomes of endovascular management for BCS with chronic accessory hepatic vein (AHV) obstruction. METHODS: In total, 68 patients with primary BCS who underwent AHV dilation with or without stenting from January 2008 to December 2018 were included in this retrospective study. The technical success rate and complications were recorded...
May 29, 2020: European Journal of Gastroenterology & Hepatology
Hicaz Zencirkiran Agus, Gamze Babur Guler, Ali Riza Demir, Serkan Kahraman, Emre Yilmaz
No abstract text is available yet for this article.
2020: Northern Clinics of Istanbul
Morgane Van Wettere, Luisa Paulatto, Lucas Raynaud, Onorina Bruno, Audrey Payancé, Aurélie Plessier, Pierre-Emmanuel Rautou, Valérie Paradis, Dominique Cazals-Hatem, Dominique Valla, Valérie Vilgrain, Maxime Ronot
Background & Aims: Hepatobiliary phase (HBP) images can discriminate between benign and malignant liver lesions, but it is unclear if this approach can be used in patients with Budd-Chiari syndrome (BCS). Thus, we aimed to assess the diagnostic utility of HBP images in patients with BCS. Methods: This retrospective study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MR imaging (HBCA-MRI) from 2000 to 2019...
June 2020: JHEP reports: innovation in hepatology
Yan-Wei Zeng, Chao Liu, Mei-Pan Yin, Yue Zhao, Zhi-Wei Wang, Peng-Li Zhou, Yao-Zhen Ma, Chun-Xia Li, Gang Wu
OBJECTIVE: Our study aimed to evaluate the safety and efficacy of sequential interventional therapy for Budd-Chiari syndrome (BCS) caused by obstruction of the inferior vena cava (IVC) with fresh thrombus in the IVC. METHODS: Full medical records were obtained for 20 patients with BCS associated with fresh IVC thrombus who received sequential interventional therapy from 2014 to 2019 at our hospital. All patients underwent small-diameter percutaneous transluminal angioplasty (PTA) balloon catheter predilation combined with sequential catheter-directed thrombolysis and large-diameter PTA balloon dilation...
May 14, 2020: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Leonard Naymagon
Venous thrombosis within the hepatic vasculature is associated with a distinct array of risk factors, characteristics, and potential complication. As such, it entails unique management considerations and strategies relative to the more common categories of venous thromboembolic disease. Although broadly divided into thrombosis of the afferent vasculature (the portal venous system) and efferent vasculature (the hepatic venous system), presentations and management strategies within these groupings are heterogeneous...
May 11, 2020: Translational Research: the Journal of Laboratory and Clinical Medicine
Chalermrat Bunchorntavakul, K Rajender Reddy
Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections are common and are associated with a variety of liver manifestations. EBV and CMV infections, in immunocompetent hosts, commonly manifest as acute hepatitis, with severity varying from asymptomatic, self-limited icteric hepatitis to acute liver failure. Atypical manifestations, such as cholestasis, chronic hepatitis, precipitation of acute-on-chronic liver failure, and autoimmune hepatitis, are reported with EBV infection, whereas cholestasis, portal vein thrombosis, and Budd-Chiari syndrome are reported with CMV infection...
June 2020: Gastroenterology Clinics of North America
R X Ge, H Y Li, H M Wang, L Li, Y Y Wang, L H Zhong, X Y Wang, Y Lu, X T Wang
Objective: To explore the correlation between prenatal clinical data with etiological diagnosis and neonatal outcome in isolated fetal ascites. Methods: Totally, 36 pregnancy cases diagnosed as isolated fetal ascites by ultrasound in Provincial Hospital Affiliated to Shandong University from June 22nd, 2016 to September 28th, 2018 were collected. Invasive prenatal diagnosis was performed by taking fetal cord blood, amniotic fluid, and fetal ascites respectively for cytogenetics, molecular genetics and biochemical examination and the impact of intrauterine therapeutic procedures on neonatal outcomes was evaluated as well...
April 25, 2020: Zhonghua Fu Chan Ke za Zhi
Sudheer K Vuyyuru, Shivanand Gamanagatti, Shalimar
Budd-Chiari syndrome may rarely occur as a complication of Behcet's disease, and presentation with thrombosis of both inferior vena cava (IVC) and hepatic veins is rarer still. We present a young woman with Behcet's disease who presented with acute Budd-Chiari syndrome, with thrombosis of IVC and all 3 hepatic veins. An IVC stent was placed, followed by a transjugular intrahepatic portosystemic shunt through the IVC stent. On follow-up, despite oral anticoagulants and oral steroids, she developed recurrent thrombosis twice within a 1-year span...
March 2020: ACG Case Reports Journal
Andrea Mancuso, Michele Amata, Flavia Politi, Mario Mitra, Maria Grazia Laura Marsala, Alberto Maringhini
No abstract text is available yet for this article.
April 14, 2020: American Journal of Gastroenterology
Audrey Coilly, Pascal Potier, Pierre Broué, Ilias Kounis, Dominique Valla, Sophie Hillaire, Vincent Lambert, Danielle Dutheil, Virginia Hernández-Gea, Aurélie Plessier, Valérie Vilgrain, Christophe Bureau
No abstract text is available yet for this article.
April 2, 2020: Clinics and Research in Hepatology and Gastroenterology
Slaven Gojkovic, Ivan Krezic, Borna Vrdoljak, Dominik Malekinusic, Ivan Barisic, Andreja Petrovic, Katarina Horvat Pavlov, Marijan Kolovrat, Antonija Duzel, Mario Knezevic, Katarina Kasnik Kovac, Domagoj Drmic, Lovorka Batelja Vuletic, Antonio Kokot, Alenka Boban Blagaic, Sven Seiwerth, Predrag Sikiric
BACKGROUND: Recently, as a possible therapy resolving solution, pentadecapeptide BPC 157 therapy, has been used in alleviating various vascular occlusion disturbances. BPC 157 was previously reviewed as novel mediator of Robert cytoprotection and endothelium protection in the stomach, and gut-brain axis, beneficial therapy in gastrointestinal tract, with particular reference to vascular recruitment, ulcerative colitis and tumor cachexia, and other tissues healing. Here we raised new hypothesis about BPC 157 therapy in the Budd-Chiari syndrome in rats, rapid bypassing of the suprahepatic inferior caval vein occlusion, and rats recovery with the active and effective pharmacotherapy treatment...
March 13, 2020: World Journal of Gastrointestinal Pathophysiology
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