Viral Hepatitis and Liver Disease Website Course

Evaluating Liver Test Abnormalities

Understanding the Pathophysiology of Liver Disease

for Health Care Providers

Acute Budd-Chiari Syndrome

Back to Mild to Moderate Aminotransferase Elevation

Introduction

Hepatic venous outflow obstruction leads to hepatic congestion, resulting in hepatocellular injury.

History

Budd-Chiari syndrome (BCS) is more prevalent in women. There is an association between hepatic venous thrombosis and an underlying hypercoagulable state. BCS may present acutely with right upper quadrant pain, jaundice, ascites, and in some cases, fulminant hepatic failure.

Physical examination

Possible physical findings include:

  • Right upper quadrant tenderness
  • Hepatomegaly
  • Ascites
  • Edema

Patients with evidence of encephalopathy (confusion/asterixis) should be urgently referred to a liver specialist or a transplant center.

Laboratory investigation

In addition to the relevant investigations based on the clinical presentation, the following liver tests should be ordered:

  • Doppler ultrasound
  • Evaluation for hypercoagulable state