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Budd-Chiari Syndrome and Inferior Vena Cava Obstruction: The Asian Perspective

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Diagnostic Methods for Cirrhosis and Portal Hypertension

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Abstract

Budd-Chiari syndrome (BCS) is a group of heterogeneous liver vascular diseases characterized by hepatic outflow obstruction, with ascites, hepatomegaly, abdominal distension, and pedal edema being common manifestations in Asian patients. A step-wise diagnostic approach aiming at minimal invasiveness is currently recommended. Ultrasonography is the first line modality, and patient with inconclusive results should receive computer tomography (CT) or magnetic resonance (MR) for further investigation. Angiography is recommended as the final modality for validation due to its invasiveness, despite that it is the standard approach for identifying the extent and morphology of obstruction. Liver biopsy, on the other hand, is not a must since the rate of sampling error can be high. Although most Asian patients are idiopathic, routine etiology work-up should be performed. In addition, the existence of portal vein thrombosis should be examined, and close screening for hepatocellular carcinoma should be instituted, since its incidence in Asian patients is relatively high.

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  1. Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China

    Qiuhe Wang & Guohong Han

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  1. Qiuhe Wang
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  1. Inselspital, University of Bern, UVCM, DMLL, Hepatology Inselspital, University of Bern, Berne, Switzerland

    Annalisa Berzigotti

  2. Hospital Clinic, Hepatic Hemodynamic Laboratory Hospital Clinic, Barcelona, Spain

    Jaime Bosch

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Wang, Q., Han, G. (2018). Budd-Chiari Syndrome and Inferior Vena Cava Obstruction: The Asian Perspective. In: Berzigotti, A., Bosch, J. (eds) Diagnostic Methods for Cirrhosis and Portal Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-72628-1_17

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