Hepatic Vein Thrombosis, Veno-Occlusive Disease, and Ischemic Hepatitis

  • Eugene R. Schiff


Hepatic vein thrombosis, veno-occlusive disease, and ischemic hepatitis (shock liver) all produce pathologic changes in zone 3 of the hepatic lobules. Obstruction of the major outflow tracts of the liver will readily lead to congestion of the central veins and, if severe enough, hemorrhagic necrosis will ensue. Endothelial injury to the smaller hepatic venules will result in a similar centrilobular injury. Finally, any compromise of the delivery of oxygen to the liver as occurs in ischemic hepatitis can be anticipated to preferentially injure those hepatocytes that are the last to receive oxygen; zone 3 of the lobule. It is altogether fitting that this trio of centrilobular vascular disorders be included in this volume honoring Hyman Zimmerman. Indeed Dr. Zimmerman and his colleagues have provided the largest review on the management of oral contraceptive induced hepatic vein thrombosis.1


Hepatic Vein Inferior Vena Paroxysmal Nocturnal Hemoglobinuria Fulminant Hepatic Failure Portacaval Shunt 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Lewis JH, Tice HL, Zimmerman HJ: Budd-Chiari syndrome associated with oral contraceptive steroids. A review of treatment of 47 cases. Dig Dis Sci 28:673–682, 1983.PubMedCrossRefGoogle Scholar
  2. 2.
    Valla D, Casadevall N, Lacombe C, et al: Primary myeloproliferative disorder and hepatic vein thrombosis. Ann Intern Med 103:329–334, 1985.PubMedGoogle Scholar
  3. 3.
    Steenbergen WV, Beyls J, Vermylen J, et al: “Lupus” anticoagulant and thrombosis of the hepatic veins (Budd-Chiari syndrome). J Hepatol 3:87–94, 1986.PubMedCrossRefGoogle Scholar
  4. 4.
    Mackworth-Young CG, Melia WM, Harris EN, et al: The Budd-Chiari syndrome. Possible pathogenetic role of anti-phospholipid antibodies. J Hepatol 3:83–86, 1986.PubMedCrossRefGoogle Scholar
  5. 5.
    Levy VG, Ruskone A, Baillou C, et al: Polycythemia and the Budd-Chiari syndrome study of serum erythropoietin and bone marrow erythroid progenitors. Hepatology 5:858–861, 1985.PubMedCrossRefGoogle Scholar
  6. 6.
    Mitchell MC, Boitnott, JK, Kaufman S, et al: Budd-Chiari syndrome: Etiology, diagnosis and management. Medicine (Baltimore) 61.:199–218, 1982.Google Scholar
  7. 7.
    Reynolds TB: Budd-Chiari syndrome, in Schiff L, Schiff E (eds): Diseases of the Liver, 6th ed. JB Lippincott, Philadelphia, 1987, pp. 1466–1477.Google Scholar
  8. 8.
    Friedman AC, Ramchandani P, Black M, et al: Magnetic resonance imaging diagnosis of Budd-Chiari syndrome. Gastroenterology 91:1289–1295, 1986.PubMedGoogle Scholar
  9. 9.
    Gupta S, Barter S, Phillips GW, et al: Comparison of ultrasonography, computed tomography and 99mTc liver scan in diagnosis of Budd-Chiari syndrome. Gut 28:242–247, 1987.PubMedCrossRefGoogle Scholar
  10. 10.
    Picard M, Carrier L, Chartrand R, et al: Budd-Chiari syndrome: Typical and atypical scintigraphic aspects. J Nucl Med 28:803–809, 1987.PubMedGoogle Scholar
  11. 11.
    Mathieu D, Vasile N, Menu Y, et al: Budd-Chiari syndrome: Dynamic CT. Radiology 165:409–413,1987.PubMedGoogle Scholar
  12. 12.
    Stark DD, Hahn PF, Trey C, et al: MRI of the Budd-Chiari syndrome. AJR 146:1141–1148, 1986.PubMedGoogle Scholar
  13. 13.
    Gupta S, Blumgart LH, Hodgson JHF: Budd-Chiari syndrome: Long-term survival and factors affecting mortality. Q J Med 232:781–791, 1986.Google Scholar
  14. 14.
    Sholar PW, Bell WR: Thrombolytic therapy for inferior vena cava thrombosis in paroxysmal nocturnal hemoglobinuria. Ann Intern Med 103:539–541, 1985.PubMedGoogle Scholar
  15. 15.
    Sparano J, Chang J, Trasi S, et al: Treatment of the Budd-Chiari syndrome with percutaneous transluminal angioplasty. Am J Med 82:8821–8828, 1987.CrossRefGoogle Scholar
  16. 16.
    Fururi S, Yamauchi T, Ohtomo K, et al: Hepatic inferior vena cava obstructions: Clinical results of treatment with percutaneous transluminal laser-assisted angioplasty. Radiology 166:673–677, 1988.Google Scholar
  17. 17.
    Ahn SS, Yellin A, Sheng FC, et al: Selective surgical therapy of the Budd-Chiari syndrome provides superior survivor rates than conservative medical management. J Vasc Surg 5:28–37, 1987.PubMedGoogle Scholar
  18. 18.
    McCarthy PM, van Heerden JA, Adson MA, et al: The Budd-Chiari syndrome. Medical and surgical management of 30 patients.Arch Surg 120:657–662, 1985.PubMedCrossRefGoogle Scholar
  19. 19.
    Vons C, Bourstyn E, Bonnet P, et al: Results of Portal systemic shunts in Budd-Chiari syndrome. Ann Surg 203:366–370, 1986.PubMedCrossRefGoogle Scholar
  20. 20.
    Sarr MG, Herlong HF, Cameron JL: Long-term patency of the mesocaval C shunt. Am J Surg 151:98–103, 1986.PubMedCrossRefGoogle Scholar
  21. 21.
    Chezmar JL, Bernardino ME: Mesoatrial shunt for the treatment of Budd-Chiari syndrome: Radiologic evaluation in eight patients. AJR 149:707–710, 1987.PubMedGoogle Scholar
  22. 22.
    Bansky G, Ernest C, Jenni R, et al: Treatment of Budd-Chiari syndrome by dorsocranial liver resection and direct hepatoatrial anastomosis. J Hepatol 2:101–112, 1986.PubMedCrossRefGoogle Scholar
  23. 23.
    Rector WG, Xu Y, Goldstein L, et al. Membranous obstruction of the inferior vena cava in the United States. Medicine (Baltimore) 2:134–143, 1985.Google Scholar
  24. 24.
    Lernt J, Tzakis AG, Bron K, et al: Complications of venous reconstruction in human orthotopic liver transplantation. Ann Surg 205:404–414, 1987.CrossRefGoogle Scholar
  25. 25.
    Kumana CR, Ng M, Hsiang JL, et al: Hepatic veno-occlusive disease due to toxic alkaloid in herbal tea. Lancet 2:1360–1361, 1983.PubMedCrossRefGoogle Scholar
  26. 26.
    Shulman HM, Gown AM, Nugent DJ: Hepatic veno-occlusive disease after bone marrow transplantation. Immunohistochemical identification of the material within occluded central venules.Am J Pathol 127:549–558, 1987.PubMedGoogle Scholar
  27. 27.
    Zimmerman HJ, Maddrey WC: Toxic and drug-induced hepatitis, in Schiff L, Schiff E (eds): Diseases of the Liver. JB Lippincott, Philadelphia, 1987, pp. 591–667.Google Scholar
  28. 28.
    Doll DC, Ringenberg QS, Yarbro JW: Vascular toxicity associated with antineoplastic agents. J Clin Oncol 4:1405–1417, 1986.PubMedGoogle Scholar
  29. 29.
    Dulley FL, Kanfer EJ, Appelbaum FR, et al: Venocclusive disease of the liver after chemoradiotherapy and autologous bone marrow transplantation. Transplantation 43:870–873, 1987.PubMedGoogle Scholar
  30. 30.
    Read AE, Wiesner RH, LaBrecque DR, et al: Hepatic veno-occlusive disease associated with renal transplantation and azathioprine therapy. Ann Intern Med 104:651–655, 1986.PubMedGoogle Scholar
  31. 31.
    Setchell KD, Gosselin SJ, Welsh MB, et al: Dietary estrogens—A probable cause of infertility and liver disease in captive cheetahs. Gastroenterology 93:225–233, 1987.PubMedGoogle Scholar
  32. 32.
    Rollins BJ: Hepatic veno-occlusive disease. Am J Med 81:297–306, 1986.PubMedCrossRefGoogle Scholar
  33. 33.
    Murray JA, LaBrecque DR, Gingrich RD, et al: Successful treatment of hepatic veno-occlusive disease in a bone marrow transplant patient with side-to-side portacaval shunt. Gastroenterology 92:1073–1077, 1987.PubMedGoogle Scholar
  34. 34.
    Clements D, Hubscher S, West R, et al: Epitheloid heamangioendothelioma. J Hepatol 2:441–449, 1986.PubMedCrossRefGoogle Scholar
  35. 35.
    Rawson JS, Achord JL: Shock liver. South Med J 78:1421–1425, 1985.PubMedCrossRefGoogle Scholar
  36. 36.
    Bynum TE, Boitnott JK, Maddrey WC: Ischemic hepatitis. Dig Dis Sci 24:129–135, 1979.PubMedCrossRefGoogle Scholar
  37. 37.
    Gibson PR, Dudley FJ: Ischemic hepatitis: Clinical features, diagnosis and prognosis. Aust NZ J Med 14:822–825, 1984.CrossRefGoogle Scholar
  38. 38.
    Lefkowitch JH, Mendez L: Morphologic features of hepatic injury in cardiac disease and shock. J Hepatol 2:313–327, 1986.PubMedCrossRefGoogle Scholar
  39. 39.
    Adkison D, Hollwarth ME, Benoit JN, et al: Role of free radicals in ischemia-reperfusion injury to the liver. Acta Physiol Scand 548(suppl):101–107, 1986.Google Scholar
  40. 40.
    Arthur MJP: Reactive oxygen intermediates and liver injury. J Hepatol 6:125–131, 1988.PubMedCrossRefGoogle Scholar
  41. 41.
    Maddrey WC: Hepatic vein thrombosis (Budd-Chiari syndrome): Possible association with the use of oral contraceptives. Semin Liver Dis 7:32–39, 1987.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Eugene R. Schiff
    • 1
    • 2
  1. 1.Division of HepatologyUniversity of Miami School of MedicineUSA
  2. 2.Hepatology SectionVeterans Administration Medical CenterMiamiUSA

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