1. Venous drainage of liver is occluded by hepatic vein thrombosis.
2. It most commonly affects the young males.
3. It is associated with protein C, protein S and antithrombin III deficiency.
4. Abdominal discomfort and ascites are the most common features associated with acute thrombosis.
Select the correct answer using the code given below.
Budd-Chiari Syndrome: Correct Statements Explained
Budd-Chiari syndrome (BCS) is caused by obstruction to hepatic venous outflow, at any level from the small hepatic veins to the junction of the inferior vena cava (IVC) with the right atrium. The correct combination of statements is 1, 3 and 4.
Statement 1: Hepatic Vein Thrombosis
Correct. Budd-Chiari syndrome is, by definition, occlusion of the venous drainage of the liver due to thrombosis (or, less commonly, non-thrombotic obstruction such as a web) of the hepatic veins and/or the terminal segment of the IVC. This obstruction leads to sinusoidal congestion, portal hypertension, and hepatomegaly.
Statement 2: Demographics Affected
Incorrect. Budd-Chiari syndrome does not "most commonly" affect young males. In fact, it shows a distinct female predominance in many series, largely because of hormone-related hypercoagulable states such as pregnancy, the postpartum period, and oral contraceptive pill use. It typically presents in young to middle-aged adults, but the male-predominance claim is not supported.
Statement 3: Association with Thrombophilias
Correct. Budd-Chiari syndrome is strongly associated with underlying prothrombotic/myeloproliferative disorders. Deficiencies of protein C, protein S, and antithrombin III, along with conditions like polycythemia vera, paroxysmal nocturnal hemoglobinuria, factor V Leiden mutation, and antiphospholipid antibody syndrome, are well-recognized causes predisposing to hepatic vein thrombosis.
Statement 4: Acute Phase Features
Correct. In acute Budd-Chiari syndrome, sudden hepatic venous outflow obstruction causes hepatic congestion, presenting classically with abdominal pain/discomfort, rapidly developing ascites, and tender hepatomegaly. This acute triad (pain, ascites, hepatomegaly) is a hallmark clinical presentation.
Conclusion
- Statement 1 — Correct (defining pathology of the syndrome)
- Statement 2 — Incorrect (female preponderance, not male)
- Statement 3 — Correct (recognized thrombophilic associations)
- Statement 4 — Correct (typical acute presentation)
Since statements 1, 3, and 4 are true while statement 2 is false, the correct answer is 1, 3 and 4.
Important Questions from Hepatobiliary & Pancreatic Surgery
Which among the following are complications of liver trauma?
1. Liver abscess
2. Biliary fistula
3. Portal thrombosis
4. Liver failure
Select the correct answer using the code given below.
Which of the following are local complications of acute pancreatitis?
1. Pseudocyst
2. Pleural effusion
3. Ileus
4. Acute fluid collection
Select the correct answer using the code given below.
Which of the following are risk factors for the development of pancreatic cancer?
1. Cigarette smoking
2. Diabetes mellitus
3. Caucasian ethnicity
4. Male gender
Select the correct answer using the code given below.
Which of the following are options for management of a pancreatic pseu- docyst?
1. Pancreaticoduodenectomy
2. Cystogastrostomy
3. Percutaneous drainage
4. Endoscopic drainage
Select the correct answer using the code given below :
- Which of the following statements regarding hepatic adenomas are correct? 1. They are almost exclusively seen in females aged 25-50 years 2. They are associated with use of oral contraceptive pills 3. They do not have any malignant potential 4. Majority are detected incidentally on imaging Select the correct answer using the code given below :
