Which of the following is an example of vascular liver disease?

• A. Portal hypertension
• B. Budd-Chiari syndrome
• C. Fatty liver
• D. Cirrhosis

Answer: (B)

Vascular liver disease refers to conditions that disrupt the liver’s blood flow, especially the outflow through the hepatic veins. Budd-Chiari syndrome fits this because it is an obstruction of the hepatic venous outflow (or nearby inferior vena cava), leading to hepatic venous congestion, hepatomegaly, and ascites — a direct vascular problem within the liver’s circulation.

Portal hypertension, while a vascular phenomenon, is best viewed as the elevated pressure in the portal venous system that often arises secondarily to liver disease rather than a primary vascular disease of the liver itself. Fatty liver involves fat accumulation in hepatocytes, a metabolic/parenchymal change. Cirrhosis is scarring and architectural distortion of the liver tissue, a parenchymal disease rather than a primary vascular obstruction.