What are the main clinical features of Budd-Chiari syndrome?

• abdominal pain: sudden onset, severe
• ascites → abdominal distension
• tender hepatomegaly

What are the main causes of Budd-Chiari syndrome?

usually seen in the context of underlying haematological disease or another procoagulant condition

• polycythaemia rubra vera
• thrombophilia: activated protein C resistance, antithrombin III deficiency, protein C & S deficiencies
• pregnancy
• combined oral contraceptive pill: accounts for around 20% of cases

What is the pathophysiology of Budd-Chiari syndrome?

hepatic vein thrombosis

What is the investigation of choice for Budd-Chiari syndrome?

ultrasound with Doppler flow studies