What disease presents with thrombosed hepatic veins?

• A. Budd-Chiari Syndrome
• B. Hepatic adenoma
• C. Hepatic hemangioma
• D. Portal vein thrombosis

Answer: (A)

Hepatic venous outflow obstruction from vein thrombosis defines Budd-Chiari syndrome. When the hepatic veins are blocked, blood can't drain properly from the liver, causing increased sinusoidal pressure. This leads to hepatomegaly, right upper quadrant pain, and often ascites. The key feature is the thrombosis of the hepatic veins itself, not the portal system or a liver lesion.

Hepatic adenoma and hepatic hemangioma are benign liver lesions and don’t involve hepatic vein thrombosis as their defining problem. Portal vein thrombosis affects the inflow through the portal vein, presenting with signs of portal hypertension rather than primary hepatic venous outflow obstruction.