Blood of inferior vena cava flowing into right atrium via hepatic veins:a special type of Budd Chiari syndrome

Objective Retrospectively study a special pattern of Budd Chiari syndrome(BCS):inferior vena cava(IVC) blood flowing into right atrium via hepatic veins.Methods One hundred and fourteen patients with BCS were examined with color Doppler ultrasound.The courses,orifices and flow direction of IVC,three main hepatic veins(HVs) and the collaterals were investigated.Results Five patients with BCS were found possessing that circulation type:blood of hepatic IVC flowed into the liver through a hepatic vein,and through intrahepatic collaterals and another hepatic vein,and finally flowed into the right atrium.Diagnoses of the 5 cases were proved by interventional management.Conclusions Blood flowing of IVC via hepatic veins is a rare type of BCS.The character is the occlusion or severe stenosis of IVC accompanying two hepatic vein opened inferior and superiov to IVC obstructive segment respectively and abundant intrahepatic collaterals.Diagnosis of this special circulation pattern of BCS is significance both in vessel impairment classification and interventional strategy decision making.