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

  • Qiuhe Wang
  • Guohong Han
Chapter

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.

Keywords

Budd-Chiari syndrome Ultrasonography Computer tomography Magnetic resonance Angiography Stenting TIPS 

Notes

Acknowledgement

Conflict of Interest: The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 1.Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive DiseasesFourth Military Medical UniversityXi’anChina

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