RT Book, Section A1 Albert, Scott P. A1 Bloomston, Mark A2 Dean, Steven M. A2 Satiani, Bhagwan A2 Abraham, William T. SR Print(0) ID 1105291127 T1 BUDD-CHIARI SYNDROME T2 Color Atlas and Synopsis of Vascular Diseases YR 2015 FD 2015 PB McGraw-Hill Medical PP New York, NY SN 9780071749541 LK accesssurgery.mhmedical.com/content.aspx?aid=1105291127 RD 2024/10/05 AB A 34-year-old woman on oral contraceptive pills presents with vague right upper quadrant abdominal pain and worsening abdominal distention for the past 1 month. On examination, she has right upper quadrant tenderness with hepatomegaly. Her liver function panel shows slightly elevated serum aspartate (AST) and alanine aminotransferase (ALT) but normal bilirubin and coagulation profile. A right upper quadrant ultrasound shows hepatic venous occlusion and a moderate amount of ascites. She is started on anticoagulation as well as diuretics to manage her ascites. Her oral contraceptive pills are stopped and a hypercoagulable workup is initiated. A computed tomographic (CT) scan of her abdomen is undertaken to delineate the extent of hepatic venous thrombosis and further liver pathology. She will require close follow-up to monitor her liver dysfunction and potential intervention with percutaneous or surgical procedures in the future. Figures 48-1,48-2, and 48-3 demonstrate typical images of a patient with long-standing hepatic outflow occlusion.