Clinical significance of large spontaneous portosystemic shunts in Budd-Chiari syndrome

Abstract

Objective To explore the clinical significance of large spontaneous portosystemic shunts ( L-SPSS ) in Budd-Chiari syndrome ( B-CS ). Methods Clinical data of 382 B-CS patients treated at The First Affiliated Hospital of Zhengzhou University from Apr 2012 to Dec 2018 were analyzed retrospectively and we included 32 patients with B-CS complicated L-SPSS ( diameter>8 mm ). 65 patients without L-SPSS were selected randomly to form the control group. The correlation between L-SPSS and liver function, upper gastrointestinal bleeding, ascites, hepatic encephalopathy, inferior vena cava thrombosis , portal vein diameter and splenic vein diameter were analyzed. Results TBil, Child-Pugh scores, incidence of hepatic encephalopathy, ascites and inferior vena cava thrombosis in the B-CS complicated L-SPSS group were higher than that in the B-CS without L-SPSS group . The percentage of Child-Pugh grade B and C patients in the B-CS complicated L-SPSS group were also higher than that in the B-CS without L-SPSS group. The level of ALB and hepatic volume per unit surface area were both significantly less in the experimental group.( P 0.05 ) . Conclusions For those B-CS patients complicated L-SPSS , hepatic encephalopathy and ascites are more frequent, and they usually have poorer liver function. Key words: Budd-Chiari syndrome; Hypertension, portal; Collateral circulation