A 25-year-old woman develops nausea, vomiting, and abdominal pain. On examination, she has tender hepatomegaly and ascites. She was recently staed on oral contraceptives. What shall be the clinical diagnosis ?
Correct Answer: Budd -Chiari syndrome
Description: Budd-Chiari syndrome: Thrombus in hepatic veins - sinusoidal pressure | - hepatomegaly - stretching of capsule - RUQ pain Causes: 1. Hematological disorder - Polycythemia vera (JAK 2 mutation) & PNH2. Protein C/S, AT III | - | clotting tendency in body3. High estrogen leads to hypercoagulable state4. Tumors - HCC, RCC, Wilm's tumor (tumor pressing hepatic vein)5. Infections - hydatid cyst6. CTD - Behcet ds, Sarcoidosis, APLAS (Anti b2 glycoprotein)- intrinsic system activation
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