Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of the Budd-Chiari syndrome due to a web of the hepatic inferior vena cava (IVC) is reported. A 54-year-old male with mild liver dysfunction was suspected with IVC obstruction from the screening CT which revealed liver cirrhosis with marked caudate lobe enlargement and dilatation of azygous and hemiazygous vein. Subsequent radionuclide cavography with 99mTc-HSA clearly demonstrated IVC obstruction, but failed to clarify the site or type of the obstruction. Finally contrast cavography diagnosed a web of the hepatic IVC, which was treated by percutaneous transluminal angioplasty (PTA). During two-year follow-up after PTA none of the radionuclide cavographies showed reocclusion of the IVC and as a result contrast cavography was avoided. Radionuclide cavography, therefore, was a useful method for evaluating IVC obstruction before and after PTA for the Budd-Chiari web.
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PMID:[Radionuclide cavography before and after percutaneous transluminal angioplasty in Budd-Chiari web: case report]. 189 61

To evaluate the diagnostic value of radionuclide inferior veno-cavagraphy (RIVC) for Budd-Chiari Syndrome, RIVC using Tc99m was performed on 106 patients with massive ascites. A positive RIVC result was defined as having at least two of the three following criteria: (1) a delay of more than 4 seconds in visualizing the heart; (2) sharply truncated inferior vena cava with marked hang-up of isotope activity; and (3) extensive collateral circulation. Of the 106 patients, 18 were RIVC positive and were later confirmed by operation or contrast venography to have Budd-Chiari Syndrome with IVC obstruction. Of the remaining 88 RIVC negative patients, 3 were shown by operation, computerized tomography and cardiac echo, respectively, to be Budd-Chiari Syndrome with IVC obstruction. Thus, the diagnostic sensitivity and specificity of RIVC for this syndrome was 85.7% and 100% respectively. If RIVC is combined with hepatic scintigraphy, it will help to elucidate the anatomic and functional change of IVC, as well as, liver parenchymal disease, such as liver cirrhosis, hepatic tumor or hepatic vein obstruction. RIVC is a simple safe, accurate, noninvasive and reproducible procedure. This study confirms the high diagnostic specificity and sensitivity of RIVC. We therefore recommend RIVC as the first-line study for IVC patency. Contrast venography may be used as a confirmatory study in preparation for surgical intervention.
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PMID:[The diagnostic value of radionuclide inferior veno-cavagraphy in Budd-Chiari syndrome]. 259 48

The Doppler spectrum of the normal inferior vena cava (IVC) shows a majority of flow toward the right atrium, with wide variations in flow velocity and direction owing to effects of the cardiac and respiratory cycles. Seventeen subjects underwent duplex sonography: nine children after liver transplantation, two children with right upper quadrant neuroblastoma, and six healthy control subjects. In six children the spectrum obtained from the IVC bore a strong resemblance to the unidirectional, low-velocity, continuous-flow pattern associated with the portal vein; these children included two children with biliary atresia and cirrhosis, two liver transplant recipients, and two children with IVC compression by neoplasm. In healthy children and adults, a pseudoportal Doppler signal in the IVC can be generated by subcostal right upper quadrant compression. The pseudoportal IVC appears to be a sign of partial IVC obstruction. Knowledge of this potential pitfall and meticulous morphologic imaging can help prevent mistaking the IVC for a patent portal vein.
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PMID:Pseudoportal Doppler signal in the partially obstructed inferior vena cava. 264 43

Hepatic venous outflow obstruction also called the Budd-Chiari syndrome is increasingly being recognized as a cause of portal hypertension. In western countries the obstruction is usually in the hepatic veins while in reports from South Africa, Japan and India the predominant cause is a block in the IVC at the level of the diaphragm above the entry of the hepatic veins. A hypercoagulable state caused by myeloproliferative haematological disorders, clonal defects in haemopoietic stem cells, lupus anticoagulant, contraceptive pills and postpartum state are some of the aetiological conditions described. However in 25% to 75% cases no cause can be identified. The predominant presenting features in patients with hepatic vein obstruction are hepatomegaly and ascites while those with IVC obstruction show prominent veins on the trunk and back. Ultrasound examination should be the first investigative step. However a liver biopsy is the gold standard of diagnosis. To confirm the site of obstruction inferior vena cavography or functional hepatography may be required. In the acute phase thrombolytic therapy may be useful but for established cases either surgical intervention in the form of shunts or recently balloon angioplasty may be helpful. For patients with established cirrhosis and end-stage liver failure the only alternative is liver transplantation. All these patients however should be put on long term anticoagulants to prevent rethrombosis. Some series have reported that upto 45% of patients may develop hepatocellular carcinoma on long term followup. With proper management a larger proportion of patients can be returned to a useful productive life.
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PMID:Hepatic venous outflow obstruction. 982 3