Hepatic vein obstruction is a blockage of the hepatic vein, which carries blood away from the liver.
Hepatic vein obstruction prevents blood from flowing out of the liver and back to the heart. This blockage can cause liver damage. Obstruction of this vein can be caused by a tumor or growth pressing on the vessel, or by a clot in the vessel (hepatic vein thrombosis).
Most often, it is caused by conditions that make blood clots more likely to form, including:
- Abnormal growth of cells in the bone marrow (myeloproliferative disorders)
- Chronic inflammatory or autoimmune diseases
- Inherited (hereditary) or acquired problems with blood clotting
- Oral contraceptives
Hepatic vein obstruction is the most common cause of Budd-Chiari syndrome.
- Abdominal swelling or stretching
- Pain in the right upper abdomen
- Vomiting blood
- Yellowing of the skin (jaundice)
Exams and Tests
One of the signs is swelling of the abdomen from fluid buildup (ascites). The liver is often swollen and tender.
CT scan or MRI of the abdomen
- Doppler ultrasound of the liver veins
Liver function tests
Ultrasound of the liver
Treatment varies, depending on the cause of the blockage.
- Blood-thinning (anticoagulation) medications
- Clot-busting drugs (thrombolytic treatment)
- Treatment for the liver disease, including ascites
Angioplasty and stent placement
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Venous shunt surgery
Hepatic vein obstruction can get worse and lead to liver failure, which can be life-threatening.
When to Contact a Medical Professional
Call your health care provider if:
- You have symptoms of hepatic vein obstruction
- You are being treated for this condition and you develop new symptoms
Budd-Chiari syndrome; Hepatic veno-occlusive disease
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