Approach to the spectrum of Budd-Chiari syndrome: which patients require portal decompression?

Am J Surg. 1985 Jan;149(1):167-76. doi: 10.1016/s0002-9610(85)80028-3.


Budd-Chiari syndrome (occlusion of the hepatic veins) represents a spectrum disorder. From 1974 to 1984, 20 patients with the syndrome were managed. Eleven required shunt surgery (Group 1) and 5 were managed with nonshunt therapy (Groups 2 and 3). Results have been good. Retrospective review of the liver biopsy specimens showed that Group 1 patients had a greater degree of zone 3 necrosis than Group 2 and 3 patients. We submit that presence of zone 3 necrosis on an initial liver biopsy specimen may define the failing liver of Budd-Chiari syndrome that requires conversion of the portal vein to an outflow tract by shunting.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Biopsy
  • Budd-Chiari Syndrome / classification
  • Budd-Chiari Syndrome / pathology*
  • Budd-Chiari Syndrome / surgery
  • Budd-Chiari Syndrome / therapy
  • Female
  • Humans
  • Liver / pathology*
  • Liver Function Tests
  • Male
  • Middle Aged
  • Portasystemic Shunt, Surgical*
  • Retrospective Studies