Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting
Introduction: Budd-Chiari syndrome (BCS) is a rare condition affecting one in a million adults. BCS involves outflow obstruction in the hepatic venous system, which can occur anywhere between the small hepatic veins and the atrio-caval junction and cannot be due to heart, pericardial, or hepatic ven...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2021;volume=10;issue=8;spage=3154;epage=3158;aulast= |
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| author | Emiko Sultana M Tasdik Hasan Hassan Rushekh Mahmood Adnan Ansar Vivek Podder Khan Emrul Md Yusuf Ali |
| author_facet | Emiko Sultana M Tasdik Hasan Hassan Rushekh Mahmood Adnan Ansar Vivek Podder Khan Emrul Md Yusuf Ali |
| author_sort | Emiko Sultana |
| collection | DOAJ |
| description | Introduction: Budd-Chiari syndrome (BCS) is a rare condition affecting one in a million adults. BCS involves outflow obstruction in the hepatic venous system, which can occur anywhere between the small hepatic veins and the atrio-caval junction and cannot be due to heart, pericardial, or hepatic veno-occlusive disease. Case Presentation: We report an exceedingly rare form of BCS with less common initial clinical features in a young poor adult male patient which ignited a diagnostic uncertainty and a therapeutic challenge. The presence of the classical triad of BCS in the absence of major hepatic vein obstruction prompted the medical team to consider that the patient had a rare form of BCS. In this case, the financial condition of the patient and limited resources available restricted our ability to advance into the specific investigations. However, the patient was given symptomatic medical treatment and was followed up monthly. We also provided the patient with a statement that reaffirmed our inability to provide affordable surgical management options and called for an optimized national clinical guideline that could help the physicians deal with the challenges. Conclusion: An uncommon form of BCS in this patient provided a diagnostic challenge and therapeutic uncertainty in the low-resource settings. Primary care physicians should commence evidenced medical management based on clinical suspicion acknowledging the fact that obstruction of small hepatic veins is often not detected on an ultrasound. |
| first_indexed | 2024-12-16T09:30:07Z |
| format | Article |
| id | doaj.art-59079bec21524a46b454151907b15e1c |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-12-16T09:30:07Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-59079bec21524a46b454151907b15e1c2022-12-21T22:36:33ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632021-01-011083154315810.4103/jfmpc.jfmpc_2213_20Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource settingEmiko SultanaM Tasdik HasanHassan Rushekh MahmoodAdnan AnsarVivek PodderKhan EmrulMd Yusuf AliIntroduction: Budd-Chiari syndrome (BCS) is a rare condition affecting one in a million adults. BCS involves outflow obstruction in the hepatic venous system, which can occur anywhere between the small hepatic veins and the atrio-caval junction and cannot be due to heart, pericardial, or hepatic veno-occlusive disease. Case Presentation: We report an exceedingly rare form of BCS with less common initial clinical features in a young poor adult male patient which ignited a diagnostic uncertainty and a therapeutic challenge. The presence of the classical triad of BCS in the absence of major hepatic vein obstruction prompted the medical team to consider that the patient had a rare form of BCS. In this case, the financial condition of the patient and limited resources available restricted our ability to advance into the specific investigations. However, the patient was given symptomatic medical treatment and was followed up monthly. We also provided the patient with a statement that reaffirmed our inability to provide affordable surgical management options and called for an optimized national clinical guideline that could help the physicians deal with the challenges. Conclusion: An uncommon form of BCS in this patient provided a diagnostic challenge and therapeutic uncertainty in the low-resource settings. Primary care physicians should commence evidenced medical management based on clinical suspicion acknowledging the fact that obstruction of small hepatic veins is often not detected on an ultrasound.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2021;volume=10;issue=8;spage=3154;epage=3158;aulast=budd-chiari syndromesmall hepatic veinlow-resource setting |
| spellingShingle | Emiko Sultana M Tasdik Hasan Hassan Rushekh Mahmood Adnan Ansar Vivek Podder Khan Emrul Md Yusuf Ali Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting Journal of Family Medicine and Primary Care budd-chiari syndrome small hepatic vein low-resource setting |
| title | Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting |
| title_full | Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting |
| title_fullStr | Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting |
| title_full_unstemmed | Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting |
| title_short | Budd-Chiari syndrome in small hepatic veins: A diagnostic and therapeutic challenge in a low resource setting |
| title_sort | budd chiari syndrome in small hepatic veins a diagnostic and therapeutic challenge in a low resource setting |
| topic | budd-chiari syndrome small hepatic vein low-resource setting |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2021;volume=10;issue=8;spage=3154;epage=3158;aulast= |
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