Curriculum for Specialty Certificate Examination in Gastroenterology

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Sunday, 20 April 2014

Budd–Chiari Syndrome BCS

Hepatic vein obstruction/thrombosis
Caused by:
heamtological disorders
Anti-phospholipid sydrome
Malignancy/ HCC/leukemia
OCP

C/F:
Abd pain
Tender hepatomegaly/ caudate lope enlargement
Acites

Diagnosis:
Hepatic vengram/ doppler USS
Asitic tap: exudate SAAG less than 11 g/L (protein more than 25 g/L)
Liver Bx diagnostic

Treatment:
Underlying cause
Anticoagulant
Surgical: TIPS/Tx

 

Consider BCS if:
Picture of cirrhosis but no obvious cause + reason for hypercoagulable state
Acute hepatitis with ascites
Abnormal LFT with liver Bx showing centrilobular congestion with or with fibrosis
Acute presentation in female on OCP

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