[The usefullness of percutaneous transluminal balloon angioplasty in the management of budd-Chiari syndrome].
OBJECTIVE
Membranous obstruction is the most common cause of Budd-Chiari syndrome in Orientals. Recently, percutaneous transluminal balloon angioplasty (PTBA) has been successfully applied as a treatment of membranous obstruction. We evaluated etiologies and clinical manifestations in our cases and the usefulness of PTBA.


METHODS
Twelve cases of Budd-Chiari syndrome were analyzed.


RESULTS
50.3 years was the average age of the cases (ranging from 37 to 67 years). Major symptoms or signs were superficial collateral vessels on the chest or the abdomen in 6 cases, ascites in 3, abdominal pain in 4, hepatomegaly in 4, splenomegaly in 3, melena or hematemesis in 2, and leg edema in 2. Upper gastrointestinal endoscopy showed esophageal varices in 6 cases and two of these 6 cases had gastric varices. Of 8 cases with liver cirrhosis, 4 were classified as Child-Pugh class A and 4 as B. Four patients with cirrhosis had concurrent hepatocellular carcinoma including 1 patient who was HBs Ag positive. Etiologies were membranous obstruction in 11 cases and protein C deficiency in 1 case. The main site of obstruction was IVC in 8 and hepatic vein in 4. PTBA was successfully performed in 8 cases of membranous obstruction. During the mean follow-up period of 27.6 months (12-40 months), there were no reobstructions except in 2 cases.


CONCLUSIONS
The most common cause of Budd-Chiari syndrome in our cases was membranous obstruction of IVC. Percutaneous transluminal balloon angioplasty is a very useful treatment method.
Kim
Se Hwan
SH
Department of Internal Medicine, Fatima Hospital, Daegu, Korea. khsmhj@medigate.net
Yu
Kyung Sool
KS
Baek
Seung Min
SM
Lee
Seung Yup
SY
Kim
Hyun Su
HS
Tak
Won Young
WY
Kweon
Young Oh
YO
Kim
Sung Kook
SK
Choi
Yong Hwan
YH
Chung
Joon Mo
JM
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D008297:Male; D008875:Middle Aged; D014682:Vena Cava, Inferior