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    Publication Date: 2012-11-10
    Description: We read with interest the comprehensive review article by Rössle and Gerbes that details the management of ascites in patients with liver cirrhosis and concludes that the transjugular intrahepatic portosystemic shunt (TIPS) could manage refractory ascites more effectively than large-volume paracentesis. 1 However, there is an important issue regarding the management of ascites, which is caused by Budd-Chiari syndrome (B-CS), that the authors failed to address. In patients with chronic course, the formation of intra and extrahepatic collaterals leads to improvement of liver function and may silence this disease and make it asymptomatic. 2 Thus, collateral circulation may be of great clinical importance in guiding the treatment of B-CS. 3 Our clinical study demonstrated that TIPS was not necessary in chronic cases of B-CS. Data were available for a total of 174 B-CS patients (39% women, mean age 37 years) treated between 1998 and 2011. The imaging...
    Print ISSN: 0017-5749
    Electronic ISSN: 1468-3288
    Topics: Medicine
    Published by BMJ Publishing Group
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