Rapid Communication
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2008; 14(18): 2858-2862
Published online May 14, 2008. doi: 10.3748/wjg.14.2858
Etiology and portal vein thrombosis in Budd-Chiari syndrome
Oguz Uskudar, Meral Akdogan, Nurgul Sasmaz, Sevinc Yilmaz, Muharrem Tola, Burhan Sahin
Oguz Uskudar, Meral Akdogan, Nurgul Sasmaz, Burhan Sahin, Turkiye Yuksek Ihtisas Hospital, clinics of gastroenterology, Ankara 06010, Turkey
Sevinc Yilmaz, Turkiye Yuksek Ihtisas Hospital, hematology unit, Ankara 06010, Turkey
Muharrem Tola, Turkiye Yuksek Ihtisas Hospital clinics of radiology, Ankara 06010, Turkey
Author contributions: Uskudar O and Akdogan M contributed equally to this work; Uskudar O and Akdogan M designed research; Uskudar O, Akdogan M, Sasmaz N, Yilmaz S, Tola M, Sahin B performed research; Uskudar O and Akdogan M wrote the paper.
Correspondence to: Oguz Uskudar, Dr, Yayla Mah. 1. cadde no: 123/3, Kecioren, Ankara 06010, Turkey. ouskudar@hotmail.com
Telephone: +90-312-3788638
Fax: +90-312-3124120
Received: January 23, 2008
Revised: April 11, 2008
Published online: May 14, 2008

AIM: To research the etiology, portal vein thrombosis and other features of Budd-Chiari syndrome (BCS) patients prospectively.

METHODS: A total of 75 patients (40 female, 35 male) who were diagnosed between January 2002 and July 2004 as having BCS were studied prospectively. Findings from on physical examination, ultrasonography, duplex ultrasonography and venography were analyzed. Hemogram and blood chemistry were studied at the time of diagnosis and on each hospital visit. Bone marrow examination and immune phenotyping were performed by a hematologist when necessary. Protein C, S, antithrombin III, activated protein C resistance, and anticardiolipin antibodies, antinuclear antibodies, and anti ds-DNA were studied twice. The presence of ascite, esophageal varices, and portal thrombosis were evaluated at admission and on every visit.

RESULTS: At least one etiological factor was determined in 54 (72%) of the patients. The etiology could not be defined in 21 (28%) patients. One etiological factor was found in 39, 2 factors in 14 and 3 factors in 1 patient. The most common cause was the web (16%), the second was Hydatid disease (11%), the third was Behcet’s disease (9%). Portal vein thrombosis was present in 11 patients and at least one etiology was identified in 9 of them (82%).

CONCLUSION: Behcet’s disease and hydatid disease are more prominent etiological factors in Turkey than in other countries. Patients with web have an excellent response to treatment without signs of portal vein thrombosis while patients having thrombophilic factors more than one are prone to develop portal vein thrombosis with worse clinical outcome.

Keywords: Budd-Chiari syndrome, Etiology, Web, Behcet’s disease, Portal thrombosis