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Medical and Surgical Management of 30 Patients

Patrick M. McCarthy, MD; Jon A. van Heerden, MB, FRCS(C); Martin A. Adson, MD; Larry W. Schafer, MD; Russell H. Wiesner, MD

Arch Surg. 1985;120(6):657-662.

Abstract
• A retrospective review of 30 patients with documented Budd-Chiari syndrome disclosed an overall mortality of 57%. Medical treatment alone was associated with an 86% mortality; hepatic failure was the most common cause of death. Mortality was 31% overall for the surgical group, but there were long-term survivors among patients undergoing portacaval shunting. From this series, no single surgical procedure was found to be clearly superior. Surgical treatment with a side-to-side portacaval shunt seems to be the preferred operation when it can be performed. Surgical intervention should proceed soon after the diagnosis is made, lest extension of thrombus occur. Medical therapy most often is ineffective.

(Arch Surg 1985;120:657-662)

Author Affiliations
From the Department of Surgery (Drs McCarthy, van Heerden, and Adson) and the Division of Gastroenterology and Internal Medicine (Drs Wiesner and Schafer), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication Feb 13, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 12, 1984.

Reprint requests to Department of Surgery, Mayo Clinic, Rochester, MN 55905 (Dr van Heerden).

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