Budd-Chiari syndrome (BCS) is a rare disorder caused by obstruction of hepatic venous outflow. Symptoms depend on the speed and extent of blockage; they range from none to fulminant hepatic failure. Three clinical patterns are recognised: Acute (days–weeks)Sudden, severe right-upper-quadrant pain, rapidly accumulating ascites, tender hepatomegaly, nausea and vomiting. Jaundice, high fever and early hepatic encephalopathy may appear if massive necrosis develops. Sub-acute (weeks–3 months)Moderate ascites, gradual abdominal distension, low-grade fever, fatigue and dull hepatic pain; collaterals begin to form so jaundice is often mild or absent. Chronic (>3 months)Persistent ascites, non-tender hepatomegaly, splenomegaly, lower-limb oedema and visible abdominal wall... Learn more