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Budd Chiari Syndrome

 Syn. Budd-Chiari Syndrome , BCS , Hepatic Venous Outflow Obstruction

Signs & Symptoms

 Right upper quadrant pain #Acute
Ref: Harrison [ 84] Cecil [ 467]
Right hypochondrial pain #Acute
Ref: Epocrates [ https://online.epocrates.com/diseases/87421/Budd-Chiari-syndrome/Definition]
Severe pain #Acute
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]
Abdominal pain
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis] Cecil [ 459]

Physical Examination

 Hepatomegaly #Acute
Ref: Cecil [ 467] Epocrates [ https://online.epocrates.com/diseases/87421/Budd-Chiari-syndrome/Definition]
Jaundice #Acute
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis] Cecil [ 467]
Severe pain #Acute
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]

Lab / Serology

 Elevated serum ascites albumin gradient
Note: ≥ 1.1 g/dL
Ref: Harrison [ 284]
Ascitic fluid has high serum to ascites protein gradient #Acute
Note: due to elevated portal pressures
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]
Elevated serum alkaline phosphatase #Acute
Ref: Uptodate [ Drug InteractionsCalculatorsPCUsWhat's NewPatient EducationContents Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]

Imagin Study

 Large hepatic vein collaterals
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]
No visible flow in the hepatic veins
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]
Venous collaterals on anterior abdominal wall
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]

Complication

 Complications of Liver Cirrhosis #chronic
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis] Epocrates [ https://online.epocrates.com/diseases/87421/Budd-Chiari-syndrome/Definition]
Develop splenomegaly
Note: due to runderlying myeloproliferative disease, due to portal vein thrombosis, due to cirrhosis
Ref: Epocrates [ https://online.epocrates.com/diseases/87421/Budd-Chiari-syndrome/Definition]
Stigmata of chronic liver disease
Ref: Uptodate [ Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis]

Risk Factors

 Female
Ref: Epocrates [ https://online.epocrates.com/diseases/87432/Budd-Chiari-syndrome/Risk-Factors]
Thrombophilic disorders
Ref: Epocrates [ https://online.epocrates.com/diseases/87432/Budd-Chiari-syndrome/Risk-Factors]
40-50 age
Ref: Epocrates [ https://online.epocrates.com/diseases/87423/Budd-Chiari-syndrome/Epidemiology]

Cause

Other