• Am. J. Gastroenterol. · Jul 1998

    Case Reports

    Two-step procedure in Budd-Chiari syndrome with severe intrahepatic vena cava stenosis: vena cava stenting and portocaval shunt.

    • K J Oldhafer, M Frerker, M Prokop, H Lang, K Böker, and R Pichlmayr.
    • Division of Abdominal and Transplantation Surgery, Hannover Medical School, Germany.
    • Am. J. Gastroenterol. 1998 Jul 1;93(7):1165-6.

    AbstractBudd-Chiari syndrome is characterized by hepatic venous outflow obstruction, which often leads to death as a result of portal hypertension and liver failure. Venous decompressive shunt surgery and liver transplantation represent efficient surgical treatments of Budd-Chiari syndrome. In the case presented here, severe intrahepatic compression of the inferior vena cava (IVC) was caused by the hypertrophic caudate lobe. A mere portocaval shunt was not feasible because of a large pressure gradient across the intrahepatic stenosis. A two-step procedure with preoperative radiological dilation and stenting of the intrahepatic IVC followed by a portocaval shunt was successfully performed. Consequently, liver transplantation and its subsequent immunosuppression could be avoided.

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