The Role of a Medical Intermediate Care Unit in the Management of Budd-Chiari Syndrome: Case Series

Budd-Chiari syndrome (BCS) has a wide spectrum of presentations, from an asymptomatic status to acute liver failure (ALF). The therapeutic approach depends on disease severity and related etiology with patients with severe forms of presentation classically managed in intensive care units (ICUs). Here, we report a series of five BCS patients managed in a medical intermediate care unit (IntCU), with three of them presenting with acute liver injury. Progression to ALF was seen in three patients, two of whom died, with one being successfully submitted to liver transplantation. IntCUs allow a 24-h patient surveillance and a prompt management of BCS, with less economic impact when compared to ICUs. Mortality was related to the presence of associated comorbidities that limited therapeutic approach.

[1]  William M. Lee,et al.  Budd‐chiari syndrome causing acute liver failure: A multicenter case series , 2017, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[2]  D. Valla,et al.  EASL Clinical Practice Guidelines: Vascular diseases of the liver. , 2016, Journal of hepatology.

[3]  A. Plessier,et al.  Budd-Chiari Syndrome , 2008, La Revue de medecine interne.

[4]  D. Valla,et al.  Management of hepatic vascular diseases. , 2012, Journal of hepatology.

[5]  F. Rosendaal,et al.  Etiology, management, and outcome of the Budd-Chiari syndrome. , 2009, Annals of internal medicine.

[6]  Y. Bayraktar,et al.  Budd-Chiari syndrome: etiology, pathogenesis and diagnosis. , 2007, World journal of gastroenterology.

[7]  D. Valla,et al.  Budd-Chiari syndrome: a review by an expert panel. , 2003, Journal of hepatology.

[8]  J. Cameron,et al.  Budd‐Chiari Syndrome: Etiology, Diagnosis and Management , 1982, Medicine.