Budd-Chiari Syndrome

The Budd-Chiari syndrome is a symptom complex caused by obstruction of the hepatic veins. Budd1in his 1846 edition ofDiseases of the Liverdescribes 2 cases of suppurative inflammation of the hepatic veins and abscesses of the liver subsequent to lower extremity amputation. His third case had hepatic veins which seemed thicker and more opaque than natural. Chiari2presented the first comprehensive discussion of the disorder in which the obstruction was attributed to endophlebitis. More recently the syndrome has been noted to be caused by a variety of conditions. In fact, Palmer3records 40 specific causes, proved and speculative, of Chiari's syndrome. Although an attempt was not made to collect all the reported cases, Durham's4recent statement that "the condition is believed to be more prevalent than the approximate 115 reported cases would indicate" seems very reasonable. Obstruction of the hepatic veins by tumorous growth