title: Budd-Chiari syndrome following laparoscopic cholecystectomy.
abstract: Patients with thrombophilic disorder while undergoing intra-abdominal surgery may develop splanchnic vein thrombosis which can have dire consequences. Here we report a case of a 38-year-old female who developed acute Budd-Chiari syndrome after a laparoscopic cholecystectomy. She had polycythemia vera which was not diagnosed before surgery. In this report we want to highlight presurgical evaluation of routine biochemical tests and ultrasonography suggestive of myeloproliferative disorders were missed which led to the Budd-Chiari syndrome. We recommend a meticulous look at the routine evaluation done prior to cholecystectomy is essential.
authors.affiliation: Hematology Laboratory, Dr. Sunil Parekh's Lab, India.
authors.forename: Pooja D
authors.initials: PD
authors.lastname: Amarapurkar
authors.affiliation: Hematology Laboratory, Dr. Sunil Parekh's Lab, India.
authors.forename: Sunil J
authors.initials: SJ
authors.lastname: Parekh
authors.affiliation: Department of Interventional Radiology, Bombay Hospital & Medical Research Centre, Mumbai, India.
authors.forename: Punamiya
authors.initials: P
authors.lastname: Sundeep
authors.affiliation: Department of Gastroenterology and Hepatology, Bombay Hospital & Medical Research Centre, Mumbai, India.
authors.forename: Deepak N
authors.initials: DN
authors.lastname: Amarapurkar
keywords: ABC, acute Budd–Chiari; BCS, Budd–Chiari syndrome; Budd–Chiari syndrome; CT, computed tomography; ET, essential thrombocythemia; GB, gall bladder; IVC, inferior vena cava; JAK 2 mutation; LAP, leukocyte alkaline phosphatase score; MPD, myeloproliferative disorders; PMF, primary myelofibrosis; PNH, paroxysmal nocturnal hemoglobinuria; PV, polycythemia vera; PVT, portal venous thrombosis; RUQ, right upper quadrant; SAAG, serum ascites albumin gradient; TIPS, transjugular intrahepatic porta caval shunt; USG, ultrasonography; WBC, white blood cell; cholecystectomy; myeloproliferative disorder; polycythemia vera