title: Pseudo-Budd-Chiari Syndrome: decompensated alcoholic liver disease mimicking hepatic venous outflow obstruction.
abstract: Three patients with rapid onset decompensated liver disease who were referred to our hospital with presumed Budd-Chiari syndrome are described. This diagnosis was based on marked hepatomegaly, caudate lobe hypertrophy and failure to visualize hepatic veins by Doppler-ultrasound examination. Detailed history, biochemistry, and histology were, however, highly suggestive of alcoholic liver cirrhosis with steatohepatitis-induced hepatomegaly. On angiographic examination narrowed but patent hepatic veins were demonstrated in 2 patients. A third patient died before further work-up could be performed; autopsy showed patent hepatic veins. These cases show that the radiological diagnosis of Budd-Chiari syndrome due to hepatic vein obstruction can be false positive and that suspected hepatic vein occlusion on Doppler-ultrasound should be confirmed by angiographic studies and on liver histology.
authors.affiliation: Department of Gastroenterology and Hepatology, Room Ca 326, University Hospital Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. janssen@mdl.azr.nl
authors.forename: Harry L A
authors.initials: HL
authors.lastname: Janssen
authors.forename: Adriaan C I T L
authors.initials: AC
authors.lastname: Tan
authors.forename: Hugo W
authors.initials: HW
authors.lastname: Tilanus
authors.forename: Herold J
authors.initials: HJ
authors.lastname: Metselaar
authors.forename: Pieter E
authors.initials: PE
authors.lastname: Zondervan
authors.forename: Solko W
authors.initials: SW
authors.lastname: Schalm
mesh_terms: D006502:Budd-Chiari Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006529:Hepatomegaly; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler