title: Recurrent acute Budd-Chiari syndrome after right hepatectomy: US color-Doppler vascular pattern and left hepatic vein stenting for treatment.
abstract: After extended right hepatectomy remnant liver can be affected by outflow obstruction due to torsion of the inferior vena cava or kinking of the left hepatic vein. Remnant liver fixation is therefore suggested to avoid postoperative acute Budd-Chiari syndrome. Despite remnant liver reposition during surgery, a 76-years-old woman developed complete outflow obstruction. This clinical situation, due to left hepatic vein kinking, was suspected by US examination and confirmed by CT scan that showed a pathological intrahepatic vascular pattern. Patient required urgent relaparotomy and the liver was replaced in normal position. However, recurrence of outflow obstruction occurred and it was ultimately treated by inferior vena cava angiogram with left hepatic vein stenting.
authors: Department of General Surgery and Transplantation, San Martino University Hospital, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
authors: Stefano
authors: S
authors: Di Domenico
authors: Alfredo
authors: A
authors: Rossini
authors: Francesco
authors: F
authors: Petrocelli
authors: Umberto
authors: U
authors: Valente
authors: Carlo
authors: C
authors: Ferro
mesh_terms: D000208:Acute Disease; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006503:Hepatic Veins; D006801:Humans; D008102:Liver Circulation / Q000502:physiology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D015642:Radiology, Interventional; D012008:Recurrence; D018615:Ultrasonography, Doppler, Color