Complications

Complication
Timeframe
Likelihood
short term
high

Thrombolytic therapy should be used with caution due to high risk of bleeding and secondary pulmonary embolism from the dislodged clot.[91] 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.[90]

short term
low

Acute hepatic decompensation following surgical shunting requires salvage liver transplantation.[93] This occurs due to deprivation of the liver from its major blood supply, the portal vein.

short term
low

Postoperative complications of liver transplantation include portal vein and hepatic artery thrombosis, which occur in 12% of patients.[89]

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.[92]

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.

Evaluation of upper GI bleed

variable
low

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

variable
low

Portal vein thrombosis (PVT) occurs in 15% to 20% of patients with Budd-Chiari syndrome (BCS).[81] Five-year survival in patients with BCS with concomitant PVT is 59%.[82]

variable
low

Hepatocellular carcinoma (HCC) may complicate Budd-Chiari syndrome (BCS) and cirrhosis.[94][95]

HCC prevalence between 2% and 51.6% has been reported in patients with BCS, varying with geography.[94]

Hepatoma

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