title: Approach to the spectrum of Budd-Chiari syndrome: which patients require portal decompression?
abstract: Budd-Chiari syndrome (occlusion of the hepatic veins) represents a spectrum disorder. From 1974 to 1984, 20 patients with the syndrome were managed. Eleven required shunt surgery (Group 1) and 5 were managed with nonshunt therapy (Groups 2 and 3). Results have been good. Retrospective review of the liver biopsy specimens showed that Group 1 patients had a greater degree of zone 3 necrosis than Group 2 and 3 patients. We submit that presence of zone 3 necrosis on an initial liver biopsy specimen may define the failing liver of Budd-Chiari syndrome that requires conversion of the portal vein to an outflow tract by shunting.
mesh_terms: D000328:Adult; D001706:Biopsy; D006502:Budd-Chiari Syndrome / Q000145:classification / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical; D012189:Retrospective Studies