Complications

Complication
Timeframe
Likelihood
short term
high

Thrombolytic therapy should be used with caution due to the high risk of bleeding and secondary pulmonary embolism from the dislodged clot.[90] Thrombolysis is contraindicated in patients with a history of a bleeding disorder, previous cardiovascular accident, or hypertension.

short term
medium

Bleeding complications following anticoagulant therapy and liver transplantation are reported in 40% of patients.[89]

short term
low

Acute hepatic decompensation following surgical shunting requires salvage liver transplantation.[92] This occurs due to deprivation of the liver from its major blood supply, the portal vein.

short term
low

Post-operative complications of liver transplantation include portal vein and hepatic artery thrombosis, which occur in 12% of patients.[88]

long term
medium

This condition occurs as a compensatory mechanism, as the caudate lobe has a direct venous drainage into the inferior vena cava (IVC). It results in compression and stenosis of the IVC, further contributing to existing venous congestion.[91]

variable
low

Occurs as a complication of portal hypertension. An episode of gastrointestinal bleeding is less commonly the first presenting symptom of Budd-Chiari syndrome.

variable
low

Stent stenosis, post-TIPS stent protrusion, and intrahepatic haematoma.

variable
low

Portal vein thrombosis (PVT) occurs in 15% to 20% of patients with Budd-Chiari syndrome (BCS).[80] Five-year survival in patients with BCS with concomitant PVT is 59%.[81]

variable
low

Hepatocellular carcinoma (HCC) may complicate Budd-Chiari syndrome (BCS) and cirrhosis.[93][94]

HCC prevalence between 2% and 51.6% has been reported in patients with BCS, varying with geography.[93]

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