The Budd-Chiari syndrome. Medical and surgical management of 30 patients
P. M. McCarthy, J. A. van Heerden, M. A. Adson, L. W. Schafer and R. H. Wiesner
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.
