Hepatic sarcoidosis presenting as Budd Chiari syndrome leading to cirrhosis.

Budd-Chiari Syndrome (BCS) is a rare vascular disorder of the liver caused by hepatic venous outflow obstruction, with potential primary or secondary etiologies. An exceptional presentation involves the coexistence of BCS with hepatic sarcoidosis, a granulomatous liver disease. In this case report, we describe a 40-year-old female who presented initially with elevated liver function tests, later diagnosed with hepatic sarcoidosis and subsequently developed features of BCS. Here, we emphasize the use of radiological imaging modalities with pathological correlation, to facilitate timely diagnosis and guide effective management.