Transcatheter therapy of Budd-Chiari syndrome in a child after liver transplantation: report of one case.

Abstract

Budd-Chiari syndrome is a rare, heterogenous and potentially lethal condition due to hepatic venous outflow obstruction. Classic triads include hepatomegaly, ascites and abdominal pain. Most cases are caused by abnormal coagulopathy, infection, inflammation or tumor invasion. Status post liver transplantation was rarely mentioned in the pediatric group. Here we report a case of 4-year-old girl with biliary atresia status post living donor liver transplantation. Marked ascites developed 2 months later and Budd-Chiari syndrome was diagnosed. Cardiac catheterization showed significant stenoses of the hepatic vein and inferior vena cava. Initial balloon angioplasty of inferior vena cava only resulted in mild improvement. After successful balloon angioplasty of the hepatic vein stenosis, the stenosis of the inferior vena cava improved significantly. The ascites resolved soon, and no more happened up to 8 months' follow-up.