Budd-Chiari syndrome: A rare and life-Threatening complication of Crohn's disease

Camila C. Simoes, Yezaz A. Ghouri, Shehzad Nawaz Merwat, Heather Stevenson-Lerner

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Article numberbcr-2017-222946
JournalBMJ Case Reports
Volume2018
DOIs
StatePublished - Jan 1 2018

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Budd-Chiari Syndrome
Crohn Disease
Inflammatory Bowel Diseases
Hepatocytes
Liver
Digestive System Endoscopy
Hepatomegaly
Thrombophilia
Prothrombin Time
Liver Failure
Enzymes
Colonoscopy
Pulmonary Embolism
Ascites
Anticoagulants
Atrophy
Dilatation
Albumins
Edema
Fibrosis

Keywords

  • Crohn's disease
  • liver disease
  • pathology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Budd-Chiari syndrome : A rare and life-Threatening complication of Crohn's disease. / Simoes, Camila C.; Ghouri, Yezaz A.; Merwat, Shehzad Nawaz; Stevenson-Lerner, Heather.

In: BMJ Case Reports, Vol. 2018, bcr-2017-222946, 01.01.2018.

Research output: Contribution to journalArticle

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