A 35-year-old woman with polycythemia vera presents with acute right upper quadrant pain and abdominal distension. Vital signs show BP 128/82 mmHg, HR 98/min, RR 16/min, temp 37.2°C. Physical examination reveals hepatomegaly and tense ascites. Doppler ultrasound demonstrates absent hepatic venous flow with heterogeneous liver echotexture. Laboratory studies show INR 1.8 and elevated bilirubin at 2.4 mg/dL. She denies recent trauma or alcohol use. Which diagnosis best explains these findings?
- A)Budd-Chiari syndromeGABARITO
- B)Nutcracker syndrome
- C)Acute cholecystitis
- D)Primary biliary cholangitis
- E)Portal vein thrombosis with cavernous transformation only
Explicação
Budd-Chiari syndrome is thrombosis or obstruction of the hepatic veins, leading to painful hepatomegaly, ascites, and liver congestion. Myeloproliferative disorders such as polycythemia vera are classic risk factors because of their prothrombotic state. Ver explicação completa e trilha adaptativa →