Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report
Abstract Background Budd–Chiari syndrome (BCS) is a rare vascular disorder of the liver, and acute and secondary BCS is even rarer. Case presentation A 62-year-old man with perihilar cholangiocarcinoma of Bismuth type IIIa underwent right hemi-hepatectomy with caudate lobectomy and pancreatoduodenec...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-02890-5 |
| _version_ | 1797945898396811264 |
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| author | Yuya Miura Ryo Ashida Atsushi Saiga Teiichi Sugiura Katsuhisa Ohgi Mihoko Yamada Shimpei Otsuka Takeshi Aramaki Rui Sato Katsuhiko Uesaka |
| author_facet | Yuya Miura Ryo Ashida Atsushi Saiga Teiichi Sugiura Katsuhisa Ohgi Mihoko Yamada Shimpei Otsuka Takeshi Aramaki Rui Sato Katsuhiko Uesaka |
| author_sort | Yuya Miura |
| collection | DOAJ |
| description | Abstract Background Budd–Chiari syndrome (BCS) is a rare vascular disorder of the liver, and acute and secondary BCS is even rarer. Case presentation A 62-year-old man with perihilar cholangiocarcinoma of Bismuth type IIIa underwent right hemi-hepatectomy with caudate lobectomy and pancreatoduodenectomy. Adjuvant chemoradiotherapy was performed due to a positive hepatic ductal margin. Subsequently, the disease passed without recurrence. The patient visited for acute onset abdominal pain at the 32nd postoperative month. Multidetector-row computed tomography (MDCT) showed stenosis of the left hepatic vein (LHV) root, which was the irradiated field, and thrombotic occlusion of the LHV. The patient was diagnosed with acute BCS caused by adjuvant radiotherapy. Although anticoagulation therapy was performed, the patient complained of sudden upper abdominal pain again. MDCT showed an enlarged LHV thrombus and hepatomegaly. The patient was diagnosed with exacerbated acute BCS, and stenting for the stenotic LHV root was performed with a bare stent. Although stenting for the LHV root was very effective, restenosis occurred twice due to thrombus in the existing stent, so re-stenting was performed twice. The subsequent clinical course was acceptable without recurrence or restenosis of the LHV root as of 6 months after the last stenting using a stent graft. Conclusion Although no case of BCS caused by radiotherapy has yet been reported, the present case showed that late side effect of radiotherapy can cause hepatic vein stenosis and secondary BCS. |
| first_indexed | 2024-04-10T21:02:24Z |
| format | Article |
| id | doaj.art-b4463bb1aca24e0aba95054bd4e74ab3 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-10T21:02:24Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-b4463bb1aca24e0aba95054bd4e74ab32023-01-22T12:15:45ZengBMCWorld Journal of Surgical Oncology1477-78192023-01-012111710.1186/s12957-023-02890-5Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case reportYuya Miura0Ryo Ashida1Atsushi Saiga2Teiichi Sugiura3Katsuhisa Ohgi4Mihoko Yamada5Shimpei Otsuka6Takeshi Aramaki7Rui Sato8Katsuhiko Uesaka9Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Interventional Radiology, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Interventional Radiology, Shizuoka Cancer CenterDivision of Interventional Radiology, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterAbstract Background Budd–Chiari syndrome (BCS) is a rare vascular disorder of the liver, and acute and secondary BCS is even rarer. Case presentation A 62-year-old man with perihilar cholangiocarcinoma of Bismuth type IIIa underwent right hemi-hepatectomy with caudate lobectomy and pancreatoduodenectomy. Adjuvant chemoradiotherapy was performed due to a positive hepatic ductal margin. Subsequently, the disease passed without recurrence. The patient visited for acute onset abdominal pain at the 32nd postoperative month. Multidetector-row computed tomography (MDCT) showed stenosis of the left hepatic vein (LHV) root, which was the irradiated field, and thrombotic occlusion of the LHV. The patient was diagnosed with acute BCS caused by adjuvant radiotherapy. Although anticoagulation therapy was performed, the patient complained of sudden upper abdominal pain again. MDCT showed an enlarged LHV thrombus and hepatomegaly. The patient was diagnosed with exacerbated acute BCS, and stenting for the stenotic LHV root was performed with a bare stent. Although stenting for the LHV root was very effective, restenosis occurred twice due to thrombus in the existing stent, so re-stenting was performed twice. The subsequent clinical course was acceptable without recurrence or restenosis of the LHV root as of 6 months after the last stenting using a stent graft. Conclusion Although no case of BCS caused by radiotherapy has yet been reported, the present case showed that late side effect of radiotherapy can cause hepatic vein stenosis and secondary BCS.https://doi.org/10.1186/s12957-023-02890-5Budd–Chiari syndromeAdjuvant radiotherapyStenosis of the hepatic veinRadiation-induced stenosis of the hepatic veinThe side effect of radiationStenting for the hepatic vein |
| spellingShingle | Yuya Miura Ryo Ashida Atsushi Saiga Teiichi Sugiura Katsuhisa Ohgi Mihoko Yamada Shimpei Otsuka Takeshi Aramaki Rui Sato Katsuhiko Uesaka Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report World Journal of Surgical Oncology Budd–Chiari syndrome Adjuvant radiotherapy Stenosis of the hepatic vein Radiation-induced stenosis of the hepatic vein The side effect of radiation Stenting for the hepatic vein |
| title | Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report |
| title_full | Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report |
| title_fullStr | Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report |
| title_full_unstemmed | Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report |
| title_short | Secondary Budd-Chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma: a case report |
| title_sort | secondary budd chiari syndrome occurred after adjuvant radiotherapy for perihilar cholangiocarcinoma a case report |
| topic | Budd–Chiari syndrome Adjuvant radiotherapy Stenosis of the hepatic vein Radiation-induced stenosis of the hepatic vein The side effect of radiation Stenting for the hepatic vein |
| url | https://doi.org/10.1186/s12957-023-02890-5 |
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