Budd-Chiari Syndrome

Thrombosis or compression of hepatic veins with centrilobular congestion and necrosis congestive liver disease (hepatomegaly, ascites, varices, abdominal pain, liver failure). Absence of JVD. Associated with hypercoagulable states, polycythemia vera, postpartum state, HCC. May cause nutmeg liver (mottled appearance).

Clinical Presentation: Abdominal pain, ascites, hepatomegaly

Lab Diagnostic/Finding: “Nutmeg” appearance of liver (because of chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome)