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$Unique_ID{BRK03547}
$Pretitle{}
$Title{Budd-Chiari Syndrome}
$Subject{Budd-Chiari Syndrome Hepatic Veno-Occlusive Disease Chiari's Disease
Chiari-Budd Syndrome Rokitansky's Disease Budd's Syndrome Lesions of the
Hepatic Artery Lesions of the Hepatic Venous System}
$Volume{}
$Log{}
Copyright (C) 1988, 1989 National Organization for Rare Disorders, Inc.
583:
Budd-Chiari Syndrome
** IMPORTANT **
It is possible that the main title of the article (Budd-Chiari Syndrome)
is not the name you expected. Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Hepatic Veno-Occlusive Disease
Chiari's Disease
Chiari-Budd Syndrome
Rokitansky's Disease
Budd's Syndrome
Information on the following diseases can be found in the Related
Disorders section of this report:
Lesions of the Hepatic Artery
Lesions of the Hepatic Venous System
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Budd-Chiari Syndrome is characterized by abnormal enlargement of the
liver. Swelling of the abdomen and legs occurs and increased pressure in the
portal vessels may result in serious damage to the liver.
Symptoms
Budd-Chiari Syndrome involves obstruction of the outflowing veins from either
large regions of the liver, or the entire liver. Blood clots or congenital
webbing occur at the junction of these vessels with the large vein that
carries the blood from the lower part of the body (inferior vena cava) to the
right atrium of the heart. This syndrome may begin gradually or abruptly.
There may be increased pressure (portal hypertension) in the veins carrying
blood from the gastrointestinal (GI) tract back to the heart through the
liver. Impaired liver function also develops. Liver biopsy tests show
central cell deterioration, development of fibrous growths and blockage
(occlusion) of the terminal hepatic (liver) veins. When vein blockage is
severe, onset of the disorder can be very sudden, and may be accompanied by
severe pain. If the disease is chronic, onset may be gradual. Pain in the
stomach region or right area of the abdomen, with abdominal swelling is
noticed. Some patients may only have abdominal swelling while others may
suddenly begin passing blood in their urine (hemoglobinuria). There may also
be unusual swelling (edema) of the legs.
Causes
The exact cause of approximately 70% of all cases of Budd-Chiari Syndrome is
not known. Symptoms develop due to blockage of the major veins that carry
blood from the liver to the heart. The blockage is usually due to clotting or
overgrowth of fibrous tissue in the veins. The blockage may, in some cases,
be caused by Pyrrolidizine plant alkaloids (bush tea) used in some parts of
the world as a drink. Other identified causes may be exposure to radiation,
arsenic, trauma, blood poisoning (sepsis), vinyl chloride monomer, cancer, or
some cancer chemotherapy drugs, as well as the use of birth control pills.
Affected Population
Budd-Chiari Syndrome affects males and females in equal numbers. Most cases
tend to affect patients between the ages of twenty and forty.
Related Disorders
Symptoms of the following disorders can be similar to those of Budd-Chiari
Syndrome. Comparisons may be useful for a differential diagnosis:
Lesions of the Hepatic (liver) Artery.
Hepatic Artery Blockage (occlusion) is usually caused by clotting
(thrombosis/embolism) or surgical ligation. The blockage may result in the
destruction of tissue in the liver. However, the outcome is unpredictable
since each individual reacts to these situations differently. Ballooning of
the vessel wall (aneurysm) of the hepatic artery can occur as a result of
infection, arteriosclerosis, trauma, or other disorders. Aneurysms are often
multiple and tend to rupture into the abdominal cavity (peritoneum), common
bile duct, or adjacent hollow organs. The ruptured hepatic artery aneurysm
can cause upper abdominal colic, obstructive jaundice, or gastrointestinal
(GI) tract bleeding (hemorrhage). Early surgery on the hepatic artery
aneurysm is recommended to avoid complications.
Lesions of the Hepatic Venous System.
Veno-Occlusive Disease involves injury or disease of the terminal hepatic
veins or the small hepatic vein system inside the liver. The larger branches
of the hepatic vein system are not involved. Obstruction of the flow from
the hepatic sinisoids which results in liver cell damage.
Therapies: Standard
Treatment of Budd-Chiari Syndrome is most successful if it is diagnosed
early. There are many methods of identifying Budd-Chiari Syndrome.
Conventional methods of X-ray and CT scanning may be useful. Magnetic
Resonance Imagining (MRI) and Ultrasound are also used as diagnostic
procedures. There are also various treatments. The use of balloon dilation
of veins (angioplasty) may ease high pressure in the vessel walls. The use
of high doses of the drug prednisone, or diverting blood flow from one vein
to another (shunting), may also be recommended.
Therapies: Investigational
This disease entry is based upon medical information available through
December 1988. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Budd-Chiari Syndrome, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
American Liver Foundation
1425 Pompton Ave.
Cedar Grove, N.J. 07009
(201) 857-2626
(800) 223-0179
The United Liver Foundation
11646 West Pico Blvd.
Los Angeles, CA 90064
(213) 445-4204 or 445-4200
Children's Liver Foundation
14245 Ventura Blvd.
Sherman Oaks, CA 91423
(818) 906-3021
National Digestive Diseases Information Clearinghouse
Box NDDIC
Bethesda, MD 20892
(301) 468-6344
References
INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and
Co., 1987. Pp. 236, 1067.
TREATMENT OF THE BUDD-CHIARI SYNDROME WITH PERCUTANEOUS TRANSLUMINAL
ANGIOPLASTY. CASE REPORT AND REVIEW OF THE LITERATURE. J. Sparano, et al.;
Am J Med (April, 1987, issue 82 (4)). Pp. 821-828.
RESULTS OF PORTAL SYSTEMIC SHUNTS IN BUDD-CHIARI SYNDROME. C. Vons, et
al.; Ann Surg (April, 1986, issue 203 (4)). Pp. 366-370.
COMPARISON OF ULTRASONOGRAPHY, COMPUTED TOMOGRAPHY AND 99mTc LIVER SCAN
IN DIAGNOSIS OF BUDD-CHIARI SYNDROME. S. Gupta, et al.; Gut (March, 1987,
issue 28 (3)). Pp. 242-247.