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DOI: 10.1055/s-0045-1811688
Budd–Chiari Syndrome with Patent Hepatic Veins on Imaging: Clinicoradiological Spectrum of Small Vessel Occlusion and Partial Thrombosis of Large Veins
Authors
Abstract
Budd–Chiari Syndrome (BCS) usually involves thrombosis or obstruction of major hepatic veins. However, a subset of patients can present with atypical features where hepatic veins appear patent on imaging. The authors present three such cases demonstrating either exclusive small hepatic vein involvement (SHV-BCS) or partial thrombosis of large veins. Despite patent hepatic veins on imaging, patients exhibited features of portal hypertension, with definitive diagnosis established via hepatic venography and transjugular liver biopsy. Two patients responded well to transjugular intrahepatic portosystemic shunt procedure with resolution of ascites, while one was managed conservatively. These cases underscore the diagnostic challenges posed by SHV-BCS and partial thrombosis of large hepatic veins and emphasize the importance of high clinical suspicion and invasive diagnostics in atypical presentations. Early recognition is crucial for timely intervention and favorable outcomes.
Publication History
Article published online:
15 October 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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