Budd-Chiari syndrome (BCS) results from hepatic venous outflow obstruction at any level from hepatic venules to the right atrium. Few patients respond to medical treatment (anticoagulation with or without thrombolytic therapy, diuretics). However, most patients need intervention to restore the hepatic blood flow. Restoring outflow in one of the major hepatic veins by balloon dilatation with or without stenting is the management of choice. When not possible or failed, transjugular intrahepatic portosystemic shunt (TIPS) is used. Follow up of patients after radiological intervention is crucial in order to assess patient improvement, shunt patency and function and to manage any procedure related complications.

A research article published in the World Journal of Gastroenterology addresses this question. In this study, the authors demonstrated that morbidity and mortality following angioplasty with or without stenting and TIPS are low with satisfactory outcome. This study may represent a future strategy for good selection of procedure candidates, maintenance of shunt patency by strict adherence to anticoagulation and early management of shunt dysfunction which are all crucial in clinical, laboratory and radiological improvement of BCS patients.

Reference:
Eldorry A, Barakat E, Abdella H, Abdelhakam S, Shaker M, Hamed A, Sakr M. Outcome of non surgical hepatic decompression procedures in Egyptian patients with Budd-Chiari. World J Gastroenterol 2011; 17(7): 906-913

Source:
Ye-Ru Wang
World Journal of Gastroenterology