Study on the relationship between pathological features of liver and obstruction types of hepatic vein and inferior vena cava in Budd-Chiari syndrome

Objective To study the relationship between pathological features of liver and obstruction types of hepatic vein and inferior vena cava.Methods The preoperative color Doppler ultrasonography,intraoperative the inferior vena cava angiography and selective hepatic vein angiography or percutaneous transhepatic hepatic vein angiography were performed in 27 cases to learn the circumstances of hepatic vein and inferior vena cava obstruction.The percutaneous hepatic biopsies were performed in the guidance of images to learn the pathologic changes of liver.The cases were divided into three types(hepatic vein type,inferior vena cava type,hepatic vein combined inferior vena cava type)according the vessels involved or were divided into two types(narrow type,occlusive type)according the serious degrees of vessel obstruction.The relationships between them were analyzed.Results Twenty-five specimens were satisfactory.Eleven cases were hepatic vein type,4 cases were inferior vena cava type and 10 cases were hepatic vein combined inferior vena cava type.Seven cases were narrow type and 18 cases were occlusive type.The degree of liver fibrosis was related with the degree of vessel obstruction,but the degree of hepatic sinusoid dilation and hepatic cell degeneration was not related with the degree of vessel obstruction.The pathological features of liver had no correlation with the position of obstruction.Conclusion The lesion of hepatic vein is consistent with the lesion of inferior vena cava to the injury of liver.The degree of obstruction is more important than the position of obstruction in judging the injury of liver.