title: Budd-Chiari Syndrome in a Patient with Hepatitis C.
abstract: Chronic Budd-Chiari syndrome can present with cirrhosis and signs and symptoms similar to those of other chronic liver diseases. We present a case of Budd-Chiari syndrome discovered during attempted transjugular intrahepatic portosystemic shunting in a patient with decompensated cirrhosis believed to be secondary to hepatitis C. Although the patient had hepatocellular carcinoma, the Budd-Chiari syndrome was a primary disease due to hepatic venous webs. Angioplasty was performed in this case, which resolved the patient's symptoms related to portal hypertension. Follow-up venography 5 months after angioplasty demonstrated continued patency of the hepatic veins. A biopsy was obtained in the same setting, which showed centrilobular fibrosis indicating that venous occlusion was indeed the cause of cirrhosis. It is important to consider a second disease when treating a patient with difficult to manage portal hypertension.
authors.affiliation: University of Arizona College of Medicine, Tucson, AZ 85724, USA.
authors.forename: Joseph
authors.identifier: 0000-0002-0156-3150
authors.initials: J
authors.lastname: Frankl
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Hennemeyer
authors.affiliation: Department of Pathology, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Flores
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
authors.forename: Archita P
authors.identifier: 0000-0001-8731-2370
authors.initials: AP
authors.lastname: Desai