Budd-Chiari syndrome, or hepatic vein thrombosis, is usually seen in the context of underlying haematological disease or another procoagulant condition.
Causes
- polycythaemia rubra vera
- thrombophilia: activated protein C resistance, antithrombin III deficiency, protein C & S deficiencies
- pregnancy
- combined oral contraceptive pill: accounts for around 20% of cases
The features are classically a triad of:
- abdominal pain: sudden onset, severe
- ascites → abdominal distension
- tender hepatomegaly
Investigations
- ultrasound with Doppler flow studies is very sensitive and should be the initial radiological investigation