What does hepatic vein enlargement mean

Widening of the hepatic veins is a manifestation of Budd-Chiari syndrome, a rare disease that has a great impact on patients. After all, liver health has a great impact on the overall health of the human body. There are different types of Budd-Chiari syndrome, and different types of Budd-Chiari syndrome have different symptoms. Below are some of the symptoms of Budd-Chiari syndrome.

1. Acute

It is mostly caused by complete obstruction of the hepatic vein, and the obstructive lesions are mostly thrombosis. It usually starts at the exit of the hepatic vein, and the thrombus can rapidly spread to the inferior vena cava. The onset is acute, with sudden upper abdominal pain, accompanied by nausea, vomiting, abdominal distension, and diarrhea, which is similar to fulminant hepatitis. The liver progressively enlarges and becomes tender, often accompanied by jaundice, splenomegaly, and rapidly increasing abdominal effusion, and there may also be pleural effusion. In fulminant cases, hepatic encephalopathy may develop rapidly, jaundice may worsen progressively, oliguria or anuria may occur, and complications may include disseminated intravascular coagulation (DIC), multiple organ failure (MOSF), spontaneous bacterial peritonitis (SBF), etc. Most patients may die rapidly within a few days or weeks due to circulatory failure (shock), liver failure, or gastrointestinal bleeding.

2. Subacute

The hepatic vein and inferior vena cava are often affected simultaneously or successively. Persistent ascites, liver enlargement and lower limb edema often exist at the same time, followed by superficial varicose veins of the abdominal wall, lower back and chest. The blood flow is upward, which is an important feature that distinguishes Budd-Chiari syndrome from other diseases. Jaundice and hepatosplenomegaly are only seen in 1/3 of patients and are usually mild or moderate. In many cases, ascites forms rapidly and persistently, abdominal pressure increases, and the diaphragm rises. In severe cases, abdominal compartment syndrome (ACS) may occur, causing systemic physiological disorders. Oliguria and anuria occur. The thoracic volume and lung compliance decrease, cardiac output decreases, pulmonary vascular resistance increases, and hypoxemia and acidosis occur.

3. Chronic type

The course of the disease can last for more than several years and is more common in patients with diaphragmatic obstruction. The condition is usually mild, but there are often striking physical signs, such as thick, winding, distended veins in the chest and abdominal walls, pigmentation in the foot and boot areas, and some chronic ulcers. Although there may be varying degrees of peritoneal effusion, most tend to be relatively stable. There may also be distended jugular veins, varicocele, huge inguinal hernia, umbilical hernia, hemorrhoids, etc.

Late-stage patients may develop a typical "Spider-Man" body shape due to malnutrition, protein loss, increased peritoneal effusion, and weight loss.