BUDD CHIARI SYNDROME AND POLYNEURITIS: In Vivo Diagnosis of Hepatic Vein Stenosis

A 39-year-old man with an obstruction of the hepatic vein with concomitant ascites and oedema of the lower extremities is described. The cause seems to be a congenital stenosis of the hepatic vein. At surgery there were no possibilities of relief. One cause of that failure may have been bleeding from collateral vessels caused by an earlier laparotomy. The literature on the Budd Chiari syndrome is briefly reviewed. Modern surgery combined with angiographic and catheterization techniques makes this grave disorder a potentially curable one. This should especially be possible in the case of the above mentioned congenital strictures and webs, which in increasing numbers are diagnosed. The other and various causes of this syndrome, including malignancies, septic thrombosis etc., will most likely be diagnosed at autopsy. No connection between polyneuritis and this syndrome has been mentioned in the literature, as far as we can find. The origin of the polyneuritis in our case remains undetermined. One may speculate whether a disturbed hepatic metabolism may be the cause. The co-existence of two separate diseases must also be considered.