A 35-year-old woman with polycythemia vera presents with acute onset right upper quadrant pain and abdominal distension. Vital signs show BP 128/82 mmHg, HR 98/min, RR 16/min, temperature 37.2°C. Physical examination reveals hepatomegaly and ascites; splenomegaly is absent. Abdominal ultrasound with Doppler demonstrates hepatic vein thrombosis with reversed flow. Laboratory studies show elevated transaminases and INR 1.3. Which of the following is the most likely diagnosis?
- A)Budd-Chiari syndromeGABARITO
- B)Primary sclerosing cholangitis
- C)Hepatic encephalopathy
- D)Acute cholangitis
- E)Spontaneous bacterial peritonitis
Explicação
Budd-Chiari syndrome is hepatic vein thrombosis causing painful hepatomegaly, ascites, and liver dysfunction. Hypercoagulable states such as polycythemia vera are classic risk factors. Ver explicação completa e trilha adaptativa →