Budd-Chiari syndrome complicating restorative proctocolectomy for ulcerative colitis: report of a case.
PURPOSE: This is a case of hepatic vein thrombosis presenting in a delayed fashion after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Search for a causative thrombotic condition resulted in the diagnosis of polycythemia vera, a myeloproliferative disorder associated with hypercoagulability. The polycythemia was masked by an iron deficiency associated with the ulcerative colitis.
METHODS: The history, physical, diagnostic modalities, and treatment for this patient are described, and the literature of Budd-Chiari syndrome associated with ulcerative colitis is reviewed.
RESULTS: Six cases of Budd-Chiari syndrome in the setting of ulcerative colitis are reported in the literature from 1945 to 1997.
CONCLUSIONS: Hepatic vein thrombosis is a rare complication of ulcerative colitis. The diagnosis of Budd-Chiari syndrome demands a thorough search for a hematologic condition predisposing to thrombosis. Our patient had a myeloproliferative disorder, polycythemia vera, that is associated with a hypercoagulable state. The disorder was masked by an iron deficiency associated with the ulcerative colitis. Recognition of the entity will permit successful treatment.
Published In/Presented At
Whiteford, M. H., Moritz, M. J., Ferber, A., & Fry, R. D. (1999). Budd-Chiari syndrome complicating restorative proctocolectomy for ulcerative colitis: report of a case. Diseases of the colon and rectum, 42(9), 1220–1224. https://doi.org/10.1007/BF02238579
Medicine and Health Sciences
Department of Surgery