BUDD-CHIARI SYNDROME or NOT ? Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

A 25 YO WOMAN CAME  FROM TU DU HOSPITAL FOR INFERTILITY. SHE HAD BIG
LIVER AND SPLEEN, WITH THE SUSPICION FROM 3 HOSPITALS OF  BEING OF liver CIRRHOSIS WITHOUT INFECTION FROM  HBV or HCV.

ULTRASOUND LIVER AT MEDIC= BIG LIVER AND SPLEEN, AND WE DETECTED THE  PORTAL  FLOW IS STILL NORMAL, BUT IVC IS TOO BIG AND VERY LOW FLOW.

IMAGE H=US LONGITUDINAL SCAN OF IVC. THE FLOW IS STOPPED AT THE UPPER PORTION OF LIVER BUT THE HEPATIC VEINS HAVE THE LOW FLOW.
NO ASCITIS.

UPDATING=

 MSCT ANGIO=  IVC IS TOO BIG AND VERY LATE CONTRAST FILLING, STENOSIS SUPRAHEPATIC WITH SMALL CALCIFICATION.

MANY COLLATERAL ANASTOMOSIS AT PELVIS, PERIUMBILICAL, AZYGOS, AND LIVER SCAN IS ABNORMAL DUE TO  INTRA LIVER VASCULAR HEMODYNAMICS.

 IS IT BUDD-CHIARI SYNDROME OR NOT? AND WHAT IS YOUR IDEA?

AFTER  MEDIC CONFIRMED  BUDD-CHIARI SYNDROME,  THIS PATIENT WENT TO CHORAY HOSPITAL FOR TREAT MENT WITH THE SUGGESTION

OPEN BY PASS SURGERY OR ENDO IVC DILATION IF THIS IS A CAUSE OF MOVC (Membraneous obstructive of the  vena cava..)...See attache file case reference. Obstruction of the Inferior Vena Cava With Vertebral Collaterals Color Doppler Findings, S. Boopathy Vijayaraghavan, MD, DMRD, Parasuram Ramchandran, MD and Mathew Cherian, MD
http://www.jultrasoundmed.org/content/22/2/233.full?sid=ac4b4777-28a4-4d0d-ba89-28974903c5db