Budd-Chiari Syndrome Due To Echinococcus Multilocularis Infection: A Case Report

Hepatic vein obstruction is associated to a clinical and pathological presentation named the Budd-Chiari syndrome, including hepatic sinusoidal dilatation and congestion, ascites and abdominal pain, as a result of hepatic outflow block. Echinococcal disease is caused by infection with the metacestode stage of the tapeworm Echinococcus. The most common presenting symptoms include malaise, weight loss, and right upper quadrant discomfort due to hepatomegaly. Hepatic vein invasion, typically associated to Echinococcus multilocularis has rarely been described .We provide here a detailed observation of a acute Budd-Chiari syndrome due to Echinococcus multilocularis infection. Detection of Budd-Chiari syndrome in case of Echinococcus multilocularis infection is important for the appropriate treatment. The radiological evidence of hepatic vein thrombosis, enlarged liver, increased abdominal pain, congestion around the central vein of the liver lobule at histology, elevated portal pressure, raised serum aminotransferases and presence of ascites rendered the diagnosis of the Budd-Chiari syndrome (BCS) most likely. 1

[1]  D. Sahani,et al.  Case records of the Massachusetts General Hospital. Case 15-2006. A 46-year-old woman with sudden onset of abdominal distention. , 2006, The New England journal of medicine.

[2]  P. Kamath,et al.  The Budd-Chiari syndrome. , 2004, The New England journal of medicine.

[3]  D. Valla Hepatic Vein Thrombosis (Budd-Chiari Syndrome) , 2002, Seminars in liver disease.

[4]  C. Fìlice,et al.  Echinococcosis in humans: clinical aspects, diagnosis and treatment. , 2001 .

[5]  F. Meslin,et al.  WHO/OIE manual on echinococcosis in humans and animals: a public health problem of global concern. , 2001 .

[6]  D. Valla,et al.  Cause of portal or hepatic venous thrombosis in adults: The role of multiple concurrent factors , 2000, Hepatology.

[7]  Š. Hrušovský,et al.  A twenty‐year history of alveolar echinococcosis: analysis of a series of 117 patients from eastern France , 2000, European journal of gastroenterology & hepatology.

[8]  J. Reichen,et al.  Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies. , 1999, The American journal of tropical medicine and hygiene.

[9]  F. Jacobs,et al.  Long-term disease-free survival after liver transplantation for alveolar echinococcosis. , 1996, Acta chirurgica Belgica.

[10]  G. Mufti,et al.  In vitro colony culture and chromosomal studies in hepatic and portal vein thrombosis--possible evidence of an occult myeloproliferative state. , 1990, The Quarterly journal of medicine.

[11]  J. Ludwig,et al.  Classification of hepatic venous outflow obstruction: ambiguous terminology of the Budd-Chiari syndrome. , 1990, Mayo Clinic proceedings.

[12]  J. Miguet,et al.  Alveolar echinococcosis of the liver. , 1989, Journal of hepatology.

[13]  J. D. Smyth,et al.  The Biology of Echinococcus and hydatid disease , 1986 .

[14]  D. Valla,et al.  Primary myeloproliferative disorder and hepatic vein thrombosis. A prospective study of erythroid colony formation in vitro in 20 patients with Budd-Chiari syndrome. , 1985, Annals of internal medicine.

[15]  D. Didier,et al.  Hepatic alveolar echinococcosis: correlative US and CT study. , 1985, Radiology.

[16]  W. Maier Computed tomographic diagnosis of Echinococcus alveolaris. , 1983, Hepato-gastroenterology.

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