Budd-Chiari syndrome is a liver disease caused by blocked or narrowed hepatic veins, leading to swelling, pain, and organ failure. Genetic conditions, blood clots, liver injury, infections, and tumors can contribute to the disease. Symptoms develop slowly and treatment includes medication, surgery, and liver transplantation.
Budd-Chiari syndrome is a blood vessel disease that affects the hepatic veins of the liver. It occurs when one or more veins become blocked or significantly narrowed, restricting blood flow to the heart. As a result, blood and fluids back up into the liver and spleen and cause swelling, pain, and eventual organ failure. Early diagnosis and treatment in the form of medications are important to prevent serious complications. Some patients require surgery to repair or replace a severely damaged liver.
Many different factors can contribute to venous occlusion and the onset of Budd-Chiari syndrome. Individuals who have acquired genetic conditions or diseases that cause blood clots are at higher risk. Protein C or S deficiency, high red blood cell count, sickle cell disease, and lupus are common underlying conditions. Liver injury from surgery, medication use, or physical trauma can also precede Budd-Chiari syndrome. Rarely, a serious infection or cancerous tumor can damage liver veins and lead to blockages.
In most cases, the symptoms of Budd-Chiari syndrome develop slowly over the course of several months. A person may experience fatigue and mild abdominal pain that gets worse over time. Ascites, or fluid accumulation in the abdominal cavity, is a common complication that causes pain and distension. Many people also experience swelling in their lower limbs, nausea and vomiting.
The liver expands and becomes irritated as blood continues to flow back up the organ. Over time, irritation and inflammation can cause permanent tissue scarring and disrupt normal liver function. It is possible for a person to develop jaundice, severe abdominal pain, and extreme fatigue as liver problems worsen.
A doctor might suspect Budd-Chiari syndrome based on a patient’s medical history and symptoms. Blood tests, ultrasounds, and specialized x-rays are usually done to confirm the presence of a venous occlusion and assess the severity of organ damage. If the liver is malfunctioning, a biopsy may be scheduled to check for scarring.
Treatment depends on the type and severity of symptoms. If Budd-Chiari syndrome is caught early, a patient may simply need to take anti-clotting medications and schedule regular health checkups. Later-stage complications may require fluid drainage from the abdomen and surgery to expand or bypass a damaged vein. Liver transplantation is only necessary when the organ has been permanently and severely damaged. Most patients who receive prompt treatment and follow their doctors’ instructions about lifestyle choices and medication use are able to make a full recovery.
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