Clinical Research in Cardiology

, Volume 102, Issue 2, pp 165–168 | Cite as

Secondary Budd–Chiari syndrome complicating calcified right atrial thrombosis related to ventriculoatrial shunt

  • S. H. SchirmerEmail author
  • M. Kiefer
  • Y. J. Kim
  • G. Schneider
  • H. J. Schäfers
  • V. Zimmer
Letter to the Editors


A 33-year-old female patient underwent diagnostic gynecologic laparoscopy for assessment of a cystic ovarian mass and moderate amounts of ascites. Operative exploration, unexpectedly, uncovered a coarsely multinodular liver surface suspicious of cirrhosis, and surgery was terminated by resection of the left adnexa. Histopathology of the surgical specimen and ascitic fluid analysis yielded no indication of underlying malignancy, and the patient was referred for hepatology work-up. Liver function tests were unremarkable; however, ultrasound revealed an inhomogeneous, nodular liver parenchyma with portal vein dilation and reduced portal venous flow suggestive of portal hypertension. Furthermore, the hepatic veins appeared compressed and duplex sonography failed to trace an unequivocal hepatic venous Doppler flow signal. Upper gastrointestinal endoscopy identified small esophageal varices. Comprehensive serological work-up was negative with respect to viral, metabolic, hereditary, or...


Inferior Vena Cava Hepatic Vein Esophageal Varix Cardiac Magnetic Resonance Imaging Right Atrial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

392_2012_510_MOESM1_ESM.mpg (490 kb)
Supplementary material 1 (MPG 490 kb)

Supplementary material 2 (MPG 840 kb)

Supplementary material 3 (MOV 157 kb)


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • S. H. Schirmer
    • 1
    Email author
  • M. Kiefer
    • 2
  • Y. J. Kim
    • 3
  • G. Schneider
    • 4
  • H. J. Schäfers
    • 5
  • V. Zimmer
    • 6
  1. 1.Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische IntensivmedizinUniversitätsklinikum des SaarlandesHomburg/SaarGermany
  2. 2.Klinik für NeurochirurgieUniversitätsklinikum des SaarlandesHomburg/SaarGermany
  3. 3.Institut für PathologieUniversitätsklinikum des SaarlandesHomburg/SaarGermany
  4. 4.Klinik für Diagnostische und Interventionelle RadiologieUniversitätsklinikum des SaarlandesHomburg/SaarGermany
  5. 5.Klinik für Thorax- und Herz-GefäßchirurgieUniversitätsklinikum des SaarlandesHomburg/SaarGermany
  6. 6.Klinik für Innere Medizin IIUniversitätsklinikum des SaarlandesHomburg/SaarGermany

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