Budd-Chiari syndrome with obstruction of the inferior caval vein: successful treatment by cavosplenoatrial shunt.
A 27-year-old man had a 10-month history of recurrent ascites, massive edema, and extreme fatigue. The diagnosis of Budd-Chiari syndrome with severe stenosis of the retrohepatic part of the inferior caval vein had been established. Medical treatment had failed to prevent further deterioration. A single 14 mm Gore-Tex graft (W.L. Gore & Associates, Inc. Elkton, Md.) was used to establish a cavosplenoatrial shunt. The postoperative recovery was uneventful. All signs of ascites and edema disappeared within 8 weeks after surgery. In connection with repair of a ventral hernia 8 months later, a liver biopsy specimen revealed partial normalization of liver histology and an angiography demonstrated a patent shunt. Two and a half years after the initial operation he developed a bleeding peptic ulcer demanding emergency surgery. The shunt was again found patent. Three years after the first operation the patient is free of symptoms and working full time.
D000328:Adult; D001201:Ascites / Q000209:etiology; D001807:Blood Vessel Prosthesis; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000601:surgery*; D004487:Edema / Q000209:etiology; D006325:Heart Atria / Q000601:surgery*; D006801:Humans; D008297:Male; D013162:Splenic Vein / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*