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Ezzahi M, Zaid E, Farid A, Allali S, Bouardi NE, Haloua M, Hakima A, Alami B, Boubbou M, Maaroufi M, Lamrani MYA. Budd-Chiari syndrome secondary to retro-hepatic vena cava web: An unusual cause of epigastric pain. Radiol Case Rep 2023; 18:1088-1092. [PMID: 36684614 PMCID: PMC9849858 DOI: 10.1016/j.radcr.2022.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023] Open
Abstract
Epigastric abdominal pain is a common indication for consultation. In the majority of cases, medical history, clinical examination and routine biological exams allow for an easy diagnosis. Sometimes the symptomatology is unusual, in which case it is essential to perform a complete clinical examination and to use various imaging techniques to search for eventual atypical causes. Membranous obstruction of inferior vena cava is a rare cause of such a phenomenon. We describe a Budd-Chiari syndrome caused by membranous obstruction of inferior vena cava in a 66-year-old woman with no medical history as a rare cause of epigastric abdominal pain. We will describe this clinical experience in the light of the literature and point out the contribution of radiological imaging in the diagnosis of this rare pathology.
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Key Words
- ALP, alkaline phosphatase
- ALT, alanine transaminase
- APS, antiphospholipid syndrome
- AST, aspartate aminotransferase
- Anti-LKM, anti-liver and kidney microsome
- Anti-SLA, anti-soluble liver antigen
- BCS, Budd-Chiari syndrome
- Budd-Chiari
- CT
- CT, computed tomography
- GGT, gamma-glutamyl transferase
- HBc, hepatitis B core
- HBs Ag, hepatitis B surface antigen
- HCV, hepatitis C virus
- IVC, inferior vena cava
- MOIVC
- MOIVC, membranous obstruction of inferior vena cava
- MPS, myeloproliferative syndromes
- MRI, magnetic resonance imaging
- PT, prothrombin time
- Supra-hepatic veins
- TIPS, trans-jugular intra-hepatic portosystemic shunt
- Ultrasound
- Vena cava
- WCC, white count cell
- Web
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Affiliation(s)
- Manar Ezzahi
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco,Corresponding author.
| | - Ennasery Zaid
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Aassouani Farid
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Soukayna Allali
- Department of Gastro-Hepato-Enterology - CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Nizar El Bouardi
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Meriem Haloua
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Abid Hakima
- Department of Gastro-Hepato-Enterology - CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Badreeddine Alami
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Meriem Boubbou
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Mustapha Maaroufi
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
| | - Moulay Youssef Alaoui Lamrani
- Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Centre Hospitalier Hrazem, BP:1835 Atlas, Fès, Avenue Hassan II, Fez 30050, Morocco
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