Abstract

PIP: The authors emphasize that the association of Budd-Chiari syndrome with pregnancy has not been previously stressed in reports. The 2 cases reported followed at 3-month and 2-month intervals after delivery. Symptoms in each began with acute abdominal pain followed by distention. Livers were found to be markedly enlarged and ascites was present. Ascitic fluid contained no malignant cells or tubercle bacilli. Inferior venography showed changes in the veins in the liver and vicinity characteristic of the Budd-Chiari syndrome. Liver biopsies showed congestion only. These findings are considered to be caused by thrombotic obstruction of some of the veins and narrowing of others. Hypercoagulability of the blood plays an important role. This can occur in pregnancy and in women using oral contraceptives. During the past 2 years 8 cases of this syndrome have been described by others as occurring in young women taking oral contraceptives. A redisposing factor in the authors' cases may have been rheumatic fever in childhood which so damaged the venous endothelium as to favor later thrombosis. A reveiw of the literature reveals several cases of Budd-Chiari syndrome occurring shortly after delivery. Even in cases where the syndrome appeared a number of months after delivery, the 2 events seem related. It is interesting to note that in Chiari's original description the ascites appeared 5 months after delivery.