A 7-year- old male child presented with the complaints of tense abdominal distension and swelling over feet since 1 month. The patient had repeated episodes of similar complaints since last two years with partial or complete relief after taking various forms of allopathic therapy. On imaging, Budd-Chiari syndrome was diagnosed which was hallmarked by occluded Inferior venacava (IVC), caudate lo...

Hepatic Venous outflow obstruction can rarely but significantly occur following the ‘piggy back’ technique of vena caval reconstruction. There are various mechanisms that cause hepatic venous outflow obstruction. A ‘ball valve’ type of obstruction requires the liver to be elevated. This can be achieved by placing various devices under the liver. We present our experience of using the ‘Bakri tub...

Biliary obstruction in the setting of hepatic bacterial infection has great morbidity and mortality. We developed a novel murine model to examine the effect of biliary obstruction on the clearance of hepatic Escherichia coli infection. This model may allow us to test the hypothesis that biliary obstruction itself adversely affects clearance of hepatic infections even if the bacteria are introdu...

Budd-Chiari syndrome is the generic term for different forms of hepatic venous outflow obstruction resulting in a clinical picture of portal hypertension and hepatomegaly. Three levels of venous outflow obstruction may be recognized, affecting respectively the small intrahepatic (IVC). Each level of obstruction is related to a different aetiology. Clinical manifestations range from mild symptom...

We report the case of a 67-year-old man with remnant left liver torsion causing acute hepatic venous outflow obstruction after right hepatectomy for giant hepatocellular carcinoma, which was successfully treated with surgery. After the primary surgery, he developed significant liver dysfunction and renal failure. Doppler ultrasonography disclosed gradual reduction of hepatic perfusion. Abdomina...

Figure 1: Axial contrast-enhanced computed tomography (A) shows heterogeneous hepatic parenchyma and ascites, as well as widely dilated venous collateral in the left haemithorax. The dilated venous collateral joined the middle and left hepatic veins. Sagittal CT scan (B) shows membranous obstruction of the inferior vena cava. DVC: dilated venous collateral; LHV: left hepatic vein; MHV: middle h...

Polycystic liver disease is commonly asymptomatic but may present with hepatomegaly, abdominal distension, and dull abdominal pain. Transudative ascites is a rare manifestation in these patients but may occur when portal hypertension is present resulting from associated hepatic fibrosis or after deroofing procedure of a cyst. Exudative ascites might suggest hepatic venous outflow obstruction. F...