Hepatic Vein Thrombosis (Budd-Chiari Syndrome)

What Is Hepatic Vein Thrombosis?

Hepatic vein thrombosis (HVT) is an obstruction in the veins of the liver caused by a blood clot. This condition blocks the drainage system of the liver, which impedes blood flow back to the heart. Without proper blood flow, the liver stops getting the fresh oxygen it needs to function. This can severely damage the liver and can lead to liver failure.

The symptoms caused by HVT vary from person to person. Some people may have no symptoms until the blockage causes liver damage.

HVT is also called Budd-Chiari syndrome.



What Causes Hepatic Vein Thrombosis?

Certain medications, diseases, and inherited disorders can cause HVT. Anything that can cause blood clotting in the veins of the liver may lead to HVT.

The most common causes of HVT are:

  • inherited blood disorders
  • liver cancer
  • liver trauma
  • infections
  • vein inflammation (phlebitis)
  • birth control pills
  • pregnancy
  • immunosuppressive drugs
  • autoimmune disorders
  • inflammatory disorders
  • connective tissue disorders


What Are the Symptoms of Hepatic Vein Thrombosis?

Not everyone with HVT will have noticeable symptoms in the early stages of the condition. For those who do, the most common symptoms are buildup of fluid in the abdomen and an enlarged liver. This is caused by pressure buildup behind the blockage.

Other symptoms of HVT include:

  • nausea and vomiting
  • vomiting blood
  • unexplained weight loss
  • enlarged spleen
  • swelling of lower limbs
  • abdominal pain (mainly in the upper right part of the abdomen)
  • jaundice (yellowing of the skin and eyes)

Call your doctor if you experience any of the symptoms mentioned above. Prompt treatment will prevent liver damage and give you a better outlook for recovery.



How Is Hepatic Vein Thrombosis Diagnosed?

Your doctor can diagnose HVT by taking your medical history, running blood tests, and performing a physical exam.

During the exam, your doctor will press gently on your abdomen to feel for the presence of fluid or an enlarged liver.

A blood sample can show if your liver is working properly. You may need an imaging test if the blood test results show liver damage.

Your doctor may order an ultrasound of the liver to check its size and for signs of damage. A computed tomography scan can also be used to look for obstructions and damaged tissue.

You may need a liver biopsy if your doctor spots abnormalities in your liver. They’ll remove a small piece of tissue from your liver to look for damage.

Your doctor can also measure pressure within the vein. To do this, they’ll insert a small instrument through a catheter into the hepatic vein. This procedure is called hepatic vein catheterization.



How Is Hepatic Vein Thrombosis Treated?


Anticlotting medications can often treat HVT. Medications used to dissolve blood clots are called fibrinolytic drugs. Your doctor may also prescribe anticoagulants to prevent blood clots.


Your doctor may choose to widen your hepatic vein to improve blood flow. This procedure is called percutaneous transluminal angioplasty.

During the procedure, a surgeon will feed a catheter into the blocked vein. The catheter has a deflated balloon at the tip, which the surgeon will inflate once it’s in the vein. This causes the vein to widen. Once the vein is wide enough, the surgeon will insert wire mesh into the vein. This holds it open.

Your surgeon may use transjugular intrahepatic portal-systemic shunting to redirect the blood flow away from the liver. This will release pressure on the portal vein.



Future Health Complications and Outlook

Untreated HVT can lead to liver failure. People with liver failure who don’t receive a transplant may have a three-year life expectancy.

The effectives of your treatment plan will depend on many factors, including:

  • blockage location
  • speed of treatment
  • type of treatment
  • the underlying cause of your HVT

HVT doesn’t always have noticeable symptoms in the early stages of the disease. You’ll have a better outlook if you get an early diagnosis and start treatment immediately.

Schedule regular checkups with your doctor and tell them if you’re experiencing symptoms you’re concerned about. This will make catching potentially serious health conditions in the early stages more likely. 

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