Budd-Chiari syndrome following vaginal delivery in a patient with Crohn’s disease: a case report and review of the literature

Banu Kumbak Aygun 1 , Gulser Goktolga Pinar 1 , Levent Sahin 1 , Zehra Sema Ozkan 1 , Ahmet Kursad Poyraz 2 , and Cem Aygun 3
  • 1 Department of Obstetrics and Gynecology, Firat University, Elazig, Turkey
  • 2 Department of Radiology, Firat University, Elazig, Turkey
  • 3 Department of Gastroenterology, Firat University, Elazig, Turkey
Banu Kumbak Aygun, Gulser Goktolga Pinar, Levent Sahin, Zehra Sema Ozkan, Ahmet Kursad Poyraz and Cem Aygun

Abstract

Introduction: The association of Budd-Chiari syndrome (BCS), Crohn’s disease (CD) and pregnancy is extremely rare. The successful medical treatment of BCS in the postpartum period in a woman with CD is presented.

Case report: A 28-year-old woman with CD presented with fever of 42°C and gross abdominal distention 2 days following delivery. On sonographic examination, massive ascites and hepatosplenomegaly were noted. Color Doppler ultrasonography and contrast-enhanced computed tomography revealed a thrombus in the suprahepatic inferior vena cava causing significant luminal obstruction. She was diagnosed with BCS. Medical treatment with spironolactone, furosemide, imipenem, metronidazole, and enoxaparin improved the clinical picture.

Conclusion: In a pregnant woman with CD, extreme thromboembolic events such as BCS might occur. If diagnosed early and treated in the acute phase, prognosis is fair.

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