Les derivations porto-systemiques dans le syndrome de budd-chiari avec obstruction cave inferieure

ABSTRACT

We report two cases of the Budd-Chiari syndrome with obstruction of the inferior vena cava. The Budd-Chiari syndrome was caused in the first case by recurrent hydatic cysts of the liver that surgery was impossible in one single time and in the second case to a deficit in the protein C. A meso-innominated and a meso-atrial shunts were performed respectively. The first was complicated by thrombosis after five weeks, before treatment of the hydatic cysts whereas the second was patent during 37 months. In the absence of other therapeutic alternative apart from hepatic transplantation in the Budd-Chiari syndrome with occlusion of the inferior vena cava, the porto-systemic shunts are the procedures of choice in spite of the high risk of secondary failure related essentially to graft thrombosis. However, their modality still remains to be discussed