Budd-Chiari Syndrome

Budd-Chiari Syndrome
Phuong L. Doan, MD
University of North Carolina Hospitals, Chapel Hill, NC
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Brief Description
A 41 year old male with constant and progressive right upper quadrant pain for 3 months, nausea not associated with vomiting and not associated with food, and bilateral lower quadrant compressible masses.
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References
Bogin et al. Budd-Chiari syndrome: in evolution.EurJGastroenterol Hepatol. 2005; 17:33-5.
•Denninger et al. Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 2000; 31: 587-591.
•Menonet al. The Budd-Chiari syndrome. NEJM 2004; 350: 578-585.
•Ruh et al. Management of Budd-Chiari syndrome. Digestive Diseases and Sciences 2005; 50: 540-546.
•Zettoun et al. Outcome of Budd-Chiari syndrome: a multivariate analysis of factors related to survival including surgical portosystemic shunting. Hepatology 1999; 30: 84-89
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	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_11" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(11);">
			<span style="display:none;" id="span_11">|~|/files/pdfs_images/node288899/Slide11.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide11.JPG" id="image_11"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>11</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288923"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_12" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(12);">
			<span style="display:none;" id="span_12">|~|/files/pdfs_images/node288899/Slide12.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide12.JPG" id="image_12"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>12</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288925"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_13" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(13);">
			<span style="display:none;" id="span_13">|~|/files/pdfs_images/node288899/Slide13.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide13.JPG" id="image_13"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>13</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288927"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_14" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(14);">
			<span style="display:none;" id="span_14">|~|/files/pdfs_images/node288899/Slide14.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide14.JPG" id="image_14"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>14</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288929"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_15" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(15);">
			<span style="display:none;" id="span_15">|~|/files/pdfs_images/node288899/Slide15.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide15.JPG" id="image_15"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>15</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288931"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_16" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(16);">
			<span style="display:none;" id="span_16">|~|/files/pdfs_images/node288899/Slide16.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide16.JPG" id="image_16"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>16</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288933"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_17" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(17);">
			<span style="display:none;" id="span_17">|~|/files/pdfs_images/node288899/Slide17.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide17.JPG" id="image_17"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>17</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288935"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_18" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(18);">
			<span style="display:none;" id="span_18">|~|/files/pdfs_images/node288899/Slide18.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide18.JPG" id="image_18"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>18</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288937"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_19" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(19);">
			<span style="display:none;" id="span_19">|~|/files/pdfs_images/node288899/Slide19.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide19.JPG" id="image_19"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>19</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288939"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_20" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(20);">
			<span style="display:none;" id="span_20">|~|/files/pdfs_images/node288899/Slide20.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide20.JPG" id="image_20"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>20</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288941"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_21" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(21);">
			<span style="display:none;" id="span_21">|~|/files/pdfs_images/node288899/Slide21.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide21.JPG" id="image_21"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>21</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288943"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_22" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(22);">
			<span style="display:none;" id="span_22">|~|/files/pdfs_images/node288899/Slide22.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide22.JPG" id="image_22"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>22</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288945"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_23" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(23);">
			<span style="display:none;" id="span_23">|~|/files/pdfs_images/node288899/Slide23.JPG|~|540|~|405|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/pdfs_images/node288899/Slide23.JPG" id="image_23"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>23</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_288947"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_24" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(24);">
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														<td width="94%" align="left"><strong>Image</strong></td>
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<div style="display:none;" id="last_image_slno">24</div>
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