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. 2023 Sep-Oct;13(5):923-926.
doi: 10.1016/j.jceh.2023.03.003. Epub 2023 Mar 20.

Secondary Budd-Chiari Syndrome due to Hepatic Tuberculosis in a Pediatric Patient Managed by Left Hepatic Vein Stenting

Ranjan K Patel  1 , Taraprasad Tripathy  1 , Alamellu Alagapan  1 , Amit K Satpathy  2 , Krishna Mohan Gulla  2 , Manas K Panigrahi  3
Affiliations

Secondary Budd-Chiari Syndrome due to Hepatic Tuberculosis in a Pediatric Patient Managed by Left Hepatic Vein Stenting

Ranjan K Patel et al. J Clin Exp Hepatol. 2023 Sep-Oct.
No abstract available

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Figures

Figure 1
Figure 1
(a) USG shows an enlarged left lobe with heterogeneous parenchymal echotexture, an ill-defined iso to hyperechoic mass (black arrow) involving LHV; (b, c) Colour Doppler shows monophasic flow in LHV, s/o LHV stenosis with multiple tiny intrahepatic veno-venous collaterals.
Figure 2
Figure 2
(a) Axial CECT image shows atrophied right lobe, multiple discrete and conglomerated hypoechoic lesions in the right and caudate lobe (black arrows) with enlarged and congested left lobe (white arrow); (b) Associated findings include multiple enlarged and necrotic retroperitoneal lymphadenopathy with few of them showing calcifications (white circle b).
Figure 3
Figure 3
(a) Left hepatic venogram following percutaneous transhepatic access shows long segment occlusion of LHV with multiple collaterals around the LHV and non-opacification of IVC; (b) Stricture was negotiated, and a 0.018″ guidewire (white arrow) was snared through transjugular route to obtain a through and through access. (c) The stricture was serially dilated using a 4–10 mm balloon; (d) Venogram after stent deployment (black arrow) shows free flow into the IVC (white arrow).
Figure 4
Figure 4
(a, b) Follow-up USG at one month shows the stent in situ with the flow within the stent.
See this image and copyright information in PMC

References

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