1The Second Department of Internal Medicine, Shinshu University School of Medicine, 2Department of Radiology, Shinshu University School of Medicine, 3The Second Department of Surgery, Shinshu University School of Medicine
Budd-Chiari syndrome, Ultrasonic diagnosis, Inferior right hepatic vein
Two patients with the Budd-Chiari syndrome were investigated with ultrasound. On physical examination, both cases did not show the typical superficial venous dilatation. Laboratory data for these cases gave the suspicious diagnosis of liver cirrhosis. Ultrasonic images showed the arcade between the dilated inferior right hepatic vein (IRHV) and right hepatic vein (RHV) or middle hepatic vein (MHV). These communicating veins were estimated as the bypass of the principal hepatic veins by Doppler. Obstruction of the inferior vena cava (IVC) at the diaphragma level was suspected with Doppler. Cavography and hepatic venography showed that IVC was obstructed at the diaphragma level about 2 cm in both cases and the three ordinal hepatic veins were not connected to the IVC. Large communicating veins existed between the hepatic veins and IRHV. Ultrasonography is noninvasive and useful for the diagnosis of the Budd-Chiari syndrome.