Budd-Chiari syndrome in pregnant patient with Crohn’s disease

Summary

The Budd-Chiari syndrome is a rare disorder characterized by an impairment of normal blood flow in liver veins. Flow obstruction can be located anywhere from the level of liver veins to vena cava inferior. Patients with this syndrome present with right upper quadrant abdominal pain, extension of abdominal girth due to ascites and hepatomegaly, dyspeptic disorders; but may be completely asymptomatic. In our case we describe a young pregnant woman at 8^th week of pregnancy with ileocaecal Crohn’s disease on azathioprine who was hospitalized with fever without clear symptoms of active Crohn’s disease. She was empirically treated by antibiotics, with subsequent clinical improvement. Clostridium perfringens as etiological agents of the infection was found in hemoculture. Patient underwent abdominal ultrasound after 9 months and heteroechoic structure in the area of confluence of liver veins was detected. Abdominal CT and subsequent MRI demonstrated partial thrombosis of liver veins in liver segments S6– S7 corresponding to partial Budd-Chiari syndrome. The aim of our case report is to describe a rare thrombotic complication in a patient with acquired thrombophilic condition and emphasize the need for prophylactic antithrombotic therapy in these groups of patients.

Key words:
Budd-Chiari syndrome –  hepatic vein thrombosis –  Crohn’s disease

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
8. 7. 2014

Accepted:
18. 5. 2015