Refractory hypoxemia in a 23-year-old patient with Budd-Chiari syndrome.

Abstract:

:Antiphospholipid syndrome is an autoimmune disorder characterized by a hypercoagulable state, leading to arterial and venous thrombosis. We present a 23-year-old patient, suspected of having Budd-Chiari syndrome due to antiphospholipid syndrome, who developed severe and progressive hypoxemia, requiring prolonged mechanical ventilation. After a detailed but unsuccessful workup, a contrast CT scan revealed an occluded superior vena cava and azygos vein-superior vena cava junction and massive right-to-left shunting through a network of systemic to pulmonary venous collaterals. Restoring normal blood flow from the azygos vein into the right atrium by stenting the azygos-superior vena cava junction resolved the hypoxemia immediately. Within the same procedure, the hepatic outflow obstruction was successfully treated by stenting a severe stenosis of the suprahepatic inferior vena cava caused by calcified thrombus.

journal_name

Chest

journal_title

Chest

authors

Bunge JJH,Wiersema US,Moelker A,van Bommel J,Tjwa ETTL

doi

10.1378/chest.13-2879

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

e149-e152

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)52415-X

journal_volume

146

pub_type

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