Budd-Chiari Syndrome: Illustrated Review of Current Management

John D. Horton; Francisco L. San Miguel; Jorge A. Ortiz


Liver International. 2008;28(4):455-466. 

In This Article


Budd-Chiari syndrome is a complex disease with a wide spectrum of aetiologies and presentations. A multidisciplinary approach to diagnosis and treatment is advantageous in patients with BCS. Medical therapy consists of treatment of underlying disease, anticoagulation and symptom control. Emerging technologies have offered new minimally invasive treatment modalities such as percutaneous catheter-directed thrombolysis, angioplasty, stenting and TIPS. While surgical shunting continues to play a role in the treatment of patients with BCS, its place in treatment strategies is unclear. Surgical shunting is best reserved to those institutions with significant operative experience, TIPS capability and a liver transplant programme. Liver transplantation is the treatment of choice for patients with fulminant hepatic failure or those with chronic cirrhosis and poor synthetic function. As technology continues to progress, new diagnostic and therapeutic options will likely enhance the clinician's ability to care for patients with this challenging disease.

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