[Obliterative disease of liver veins: clinical, diagnostic, therapeutic and pathogenetic aspects of Budd-Chiari syndrome (author's transl)]

Abstract

Both external and internal factors have to be thought of as causes of obliterative disease of liver veins. Pathogenetically, thrombosis or proliferative vascular disease (endophlebitis hepatica obliterans) may affect either large veins (with occlusion of the ostia) or small ones. Veno-occlusive disease, caused by pyrrolizidine derivatives, is a special form. Injection of contrast medium to the inferior vena cava and (or) the liver veins is the most important diagnostic method. In two personal cases there was secondary occlusion of the liver veins as a result of IVC thrombosis, while in a third case there was non-thrombotic proliferative disease of the wall of the small hepatic veins, closely similar to veno-occlusive disease. In a 19-year-old girl in whom thrombosis of the vena cava (with signs of liver-vein occlusion) occurred after pregnancy, revascularisation was achieved by fibrinolytic treatment.