Budd-Chiari syndrome other diagnostic studies: Difference between revisions
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{{Budd-Chiari syndrome}} | {{Budd-Chiari syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{Mazia}} | ||
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==Overview== | ==Overview== | ||
[[Liver biopsy]] and [[histology]] is a useful investigation if [[liver transplantation]] is being considered as it helps identify the degree of [[Hepatocellular Disease|hepatocellular damage]] and the degree of [[fibrosis]]. Findings on [[liver biopsy]] suggestive of Budd Chiari include high grade [[venous]] [[congestion]], centrilobular [[Atrophy|liver cell atrophy]], [[thrombi]] within the terminal [[Venules|hepatic venules]], [[Fibrosis|massive fibrosis]] in [[fulminant hepatic failure]]. [[Invasive]] [[Imaging|imaging methods]] are used to identify [[obstruction]] of the [[Venous|venous outflow]]. [[Angiography]] of the [[inferior vena cava]] and [[hepatic veins]] can be used together with interventional [[therapeutic]] procedures to restore patency of the [[vessels]]. | |||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
===Liver | Other [[Diagnostic|diagnostic studies]] of Budd-Chiari syndrome are as follows:<ref name="pmid28922103">{{cite journal |vauthors=Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A |title=Budd-Chiari Syndrome |journal=Prague Med Rep |volume=118 |issue=2-3 |pages=69–80 |year=2017 |pmid=28922103 |doi=10.14712/23362936.2017.6 |url=}}</ref><ref name="pmid26494427">{{cite journal |vauthors=Goel RM, Johnston EL, Patel KV, Wong T |title=Budd-Chiari syndrome: investigation, treatment and outcomes |journal=Postgrad Med J |volume=91 |issue=1082 |pages=692–7 |year=2015 |pmid=26494427 |doi=10.1136/postgradmedj-2015-133402 |url=}}</ref> | ||
*Liver | ===Liver biopsy and histology=== | ||
*Liver | *[[Liver biopsy]] and [[histology]] may be helpful in the [[diagnosis]] of Budd-Chiari syndrome. | ||
** | *[[Liver biopsy]] and [[histology]] is a useful investigation if [[liver transplantation]] is being considered as it helps identify the degree of [[Hepatocellular Disease|hepatocellular damage]] and the [[Fibrosis|degree of fibrosis]]. Findings on [[liver biopsy]] suggestive of Budd Chiari include: | ||
** | **High grade [[venous]] [[congestion]] | ||
** | **Centrilobular liver cell [[atrophy]] | ||
**Massive fibrosis in fulminant hepatic failure | **[[Thrombi]] within the terminal [[hepatic]] [[venules]] | ||
**[[Fibrosis|Massive fibrosis]] in [[fulminant hepatic failure]] | |||
===Angiography and venography=== | |||
*[[Angiography]] and [[venography]] may be helpful in the [[diagnosis]] of [[Budd-Chiari syndrome]]. | |||
*[[Invasive]] [[Imaging|imaging methods]] are used to identify [[obstruction]] of the [[Venous|venous outflow]]. | |||
*[[Angiography]] of the [[inferior vena cava]] and [[hepatic veins]] can be used together with interventional [[therapeutic]] procedures to restore patency of the [[vessels]]. | |||
*Findings on [[angiography]] suggestive of Budd Chiari include: | |||
**[[Hepatosplenomegaly]] | |||
**Stretched intra-[[hepatic]] [[arteries]] | |||
**Dilated hepatic [[arteries]] in patients with [[chronic]] [[disease]], [[Shunting|arteriovenous shunting]] in patients with [[chronic disease]] mottled appearance of [[liver]] | |||
**[[Sinusoidal]] [[contrast]] accumulation seen as large lakes is occasionally seen. | |||
**Cul-de-sac phenomenon consists of [[contrast]] material may progress slowly through the [[liver]], often with outflow through the [[portal vein]]. | |||
**[[Portography]] shows central [[hepatic]] enhancement of the [[liver]] with normal hepatoportal flow. | |||
**Splenoportographic findings vary according to the duration of disease. In early stages of BCS, flow within the [[portal vein]] is centripetal, associated with delayed emptying and stretched [[portal vein]] radicles. In later stages of BCS, [[Portal vein|portal venous]] flow is reversed, and the [[splenic]] and [[Portal vein|portal veins]] may not fill. | |||
==References== | ==References== | ||
Latest revision as of 20:23, 1 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
Liver biopsy and histology is a useful investigation if liver transplantation is being considered as it helps identify the degree of hepatocellular damage and the degree of fibrosis. Findings on liver biopsy suggestive of Budd Chiari include high grade venous congestion, centrilobular liver cell atrophy, thrombi within the terminal hepatic venules, massive fibrosis in fulminant hepatic failure. Invasive imaging methods are used to identify obstruction of the venous outflow. Angiography of the inferior vena cava and hepatic veins can be used together with interventional therapeutic procedures to restore patency of the vessels.
Other Diagnostic Studies
Other diagnostic studies of Budd-Chiari syndrome are as follows:[1][2]
Liver biopsy and histology
- Liver biopsy and histology may be helpful in the diagnosis of Budd-Chiari syndrome.
- Liver biopsy and histology is a useful investigation if liver transplantation is being considered as it helps identify the degree of hepatocellular damage and the degree of fibrosis. Findings on liver biopsy suggestive of Budd Chiari include:
- High grade venous congestion
- Centrilobular liver cell atrophy
- Thrombi within the terminal hepatic venules
- Massive fibrosis in fulminant hepatic failure
Angiography and venography
- Angiography and venography may be helpful in the diagnosis of Budd-Chiari syndrome.
- Invasive imaging methods are used to identify obstruction of the venous outflow.
- Angiography of the inferior vena cava and hepatic veins can be used together with interventional therapeutic procedures to restore patency of the vessels.
- Findings on angiography suggestive of Budd Chiari include:
- Hepatosplenomegaly
- Stretched intra-hepatic arteries
- Dilated hepatic arteries in patients with chronic disease, arteriovenous shunting in patients with chronic disease mottled appearance of liver
- Sinusoidal contrast accumulation seen as large lakes is occasionally seen.
- Cul-de-sac phenomenon consists of contrast material may progress slowly through the liver, often with outflow through the portal vein.
- Portography shows central hepatic enhancement of the liver with normal hepatoportal flow.
- Splenoportographic findings vary according to the duration of disease. In early stages of BCS, flow within the portal vein is centripetal, associated with delayed emptying and stretched portal vein radicles. In later stages of BCS, portal venous flow is reversed, and the splenic and portal veins may not fill.
References
- ↑ Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A (2017). "Budd-Chiari Syndrome". Prague Med Rep. 118 (2–3): 69–80. doi:10.14712/23362936.2017.6. PMID 28922103.
- ↑ Goel RM, Johnston EL, Patel KV, Wong T (2015). "Budd-Chiari syndrome: investigation, treatment and outcomes". Postgrad Med J. 91 (1082): 692–7. doi:10.1136/postgradmedj-2015-133402. PMID 26494427.