[Diagnosis and treatment of Budd-Chiari syndrome (literature review)].

OBJECTIVE

Updating of modern methods of diagnostics and treatment of Budd-Chiari syndrome (BCS), endovascular treatment tactics (balloon angioplasty, TIPS, DIPS, etc.) in order to raise awareness of this pathology among general practitioners, hepatologists, X-ray surgeons and doctors of other specialities.

MATERIAL AND

METHODS

We analysed full-text publications included in the abstract systems eLibrary, Cyberleninka, PubMed, Google Scholar mainly for the last 5 years (69%). The main focus was on diagnosis (ultrasound, CT, MRI) and treatment (anticoagulants, thrombolytics, balloon angioplasty, TIPS, liver transplantation).

RESULTS

BCS is a rare disease associated with impaired venous outflow from the liver resulting in suprahepatic portal hypertension. Etiology includes thrombosis, myeloproliferative diseases and congenital vascular anomalies. Epidemiology is variable, with a higher prevalence in Asia. The clinical picture varies from asymptomatic course to fulminant hepatic failure. The main manifestations are variceal haemorrhage and refractory ascites. Without treatment, survival is poor, with fatal outcome occurring within three years. The modern strategy implies a stepwise approach: drug therapy (anticoagulants, thrombolytics), balloon angioplasty, TIPS and radical treatment - liver transplantation.

CONCLUSION

Modern diagnostic methods and staged strategy of BCS have significantly improved treatment outcomes, based on endovascular approach and new technologies (stent grafts, intraoperative use of ultrasound, etc.). However, further research is needed to optimise approaches to early diagnosis and individualisation of therapy.