Hepatic vein obstruction (Budd-Chiari)

Hepatic vein obstruction is a blockage of the hepatic vein, which carries blood away from the liver.

Causes

Hepatic vein obstruction prevents blood from flowing out of the liver and back to the heart. This blockage can cause liver damage. Obstruction of this vein can be caused by a tumor or growth pressing on the vessel, or by a clot in the vessel (hepatic vein thrombosis).

Most often, it is caused by conditions that make blood clots more likely to form, including:

  • Abnormal growth of cells in the bone marrow (myeloproliferative disorders)
  • Cancers
  • Chronic inflammatory or autoimmune diseases
  • Infections
  • Inherited (hereditary) or acquired problems with blood clotting
  • Oral contraceptives
  • Pregnancy

Hepatic vein obstruction is the most common cause of Budd-Chiari syndrome.

Symptoms

  • Abdominal swelling or stretching
  • Pain in the right upper abdomen
  • Vomiting blood
  • Yellowing of the skin (jaundice)

Exams and Tests

One of the signs is swelling of the abdomen from fluid buildup (ascites). The liver is often swollen and tender.

Tests include:

Treatment

Treatment varies, depending on the cause of the blockage.

Medical treatments:

  • Blood-thinning (anticoagulation) medications
  • Clot-busting drugs (thrombolytic treatment)
  • Treatment for the liver disease, including ascites

Surgical treatments:

  • Angioplasty and stent placement
  • Transjugular intrahepatic portosystemic shunt (TIPS)
  • Venous shunt surgery

Possible Complications

Hepatic vein obstruction can get worse and lead to liver failure, which can be life-threatening.

When to Contact a Medical Professional

Call your health care provider if:

  • You have symptoms of hepatic vein obstruction
  • You are being treated for this condition and you develop new symptoms

Alternative Names

Budd-Chiari syndrome; Hepatic veno-occlusive disease

References

Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 146.

Update Date: 4/7/2012

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Notice: The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2012, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.