Diagnostic value of combined transhepatic venography and inferior vena cavography in chronic Budd-Chiari syndrome.

In a series of 19 patients with Budd-Chiari syndrome, transhepatic venography and inferior vena cavography were used to localize the site of hepatic outflow obstruction. Classification into two types was made on the basis of the site of obstruction. Four cases were grouped as type I, in which obstruction was localized in the hepatic vein alone, and the inferior vena cava (IVC) was patent. Fifteen cases were of type II, in which there was a well-defined obstruction in the intrahepatic portion of the IVC or ostium of a hepatic vein. This study highlights the frequent occurrence of IVC obstruction as a cause of chronic Budd-Chiari syndrome in northern India and the utility of transhepatic venography in its diagnosis.