Budd-Chiari syndrome: a rare and life-threatening complication of Crohn's disease.
| Autor: | Simoes CC; Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA., Ghouri YA; Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA., Merwat SN; Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA., Stevenson HL; Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2018 Jan 17; Vol. 2018. Date of Electronic Publication: 2018 Jan 17. |
| DOI: | 10.1136/bcr-2017-222946 |
| Abstrakt: | Budd-Chiari syndrome (BCS) is characterised by obstruction of hepatic venous outflow and may be triggered by the prothrombotic state associated with inflammatory bowel disease (IBD). We reported a case of Crohn's disease (CD) that presented with anasarca, ascites, symptomatic hepatomegaly, elevated liver enzymes, increased prothrombin time and low albumin. Oesophagogastroduodenoscopy and colonoscopy confirmed active CD. Abdominal CT showed hepatic vein thrombosis. Liver biopsy revealed severe perivenular sinusoidal dilation with areas of hepatocyte dropout, bands of hepatocyte atrophy and centrizonal fibrosis, suggestive of BCS. The patient was treated with steroids for CD and systemic anticoagulants for BCS. His liver function and enzymes normalised, and he reported symptomatic improvement. The precise mechanism responsible for increased hypercoagulability in IBD remains unclear. Early recognition and treatment for possible thrombotic complications of CD is critical to prevent potentially fatal events like pulmonary embolism or liver failure. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.) |
| Databáze: | MEDLINE |
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