JOURNAL OF ULTRASOUND IN MEDICINE, vol.27, no.12, pp.1787-1790, 2008 (SCI-Expanded)
Occlusion of the hepatic veins (HVs) comprises of a continuum from asymptomatic occlusion to full-blown Budd-Chiari syndrome (BCS). Recently, segmental BCS has been described, which is defined as asymptomatic segmental occlusion of an HV with development of characteristic hepaticohepatic shunts.(1) The formation of intraparenchymal hepatic venovenous shunts is the compensatory effort of the liver to continue its venous outflow. To the best of our knowledge, no ectatic venous vascular entanglement at the venocaval junction due to the distal short segmental occlusion of the middle and left HVs has been reported before. We refer to this condition as "cavernomatous transformation of the hepatic veins," which has an appearance similar to that of cavernomatous transformation of the portal vein. The case described here involves a patient who did not have the classic clinical and laboratory findings but was found on sonography to have short-segment occlusion of the HVs with compensatory intrahepatic collateral flow.