Síndrome de Budd Chiari: revisión de tema

  • Simón Correa Gaviria
  • Ana Catalina Ramírez
  • Yeinis Paola Espinoza Herrera
  • Juan Carlos Restrepo Gutiérrez
Palabras clave: Síndrome de Budd-Chiari, Ultrasonografía Doppler, Tomografía, Angiografía de Sustracción Digital, Trasplante de hígado

Resumen

El Síndrome de Budd-Chiari (SBC) es una entidad poco usual; su incidencia se calcula de uno en cien mil. Consiste en una obstrucción completa o parcial del flujo venoso localizada en cualquier lugar desde las pe- queñas venas hepáticas hasta la porción suprahepática de la vena cava inferior. De acuerdo con su etiología puede clasificarse en: primario (cuando la obstrucción se debe a una enfermedad venosa), o secundario (cuando se atribuye a una compresión extrínseca o a la invasión por una lesión que se origina fuera de las venas como neoplasias o quistes). En la mayoría de los casos se presenta como un cuadro de inicio súbito de dolor abdominal, ascitis y hepatomegalia, pudiendo ser asintomático. El diagnóstico definitivo se establece por estudios de imagen; si bien deben solicitarse exámenes básicos de laboratorio y estudios de extensión. Las modalidades de imagen incluyen la ultrasonografía Doppler, la tomografía computarizada, la resonancia magnética y la angiografía por sustracción digital, que es considerada el patrón de oro. La primera medida terapéutica que debe emprenderse en estos pacientes es la anticoagulación con heparina de bajo peso molecular, seguida de antagonistas de vitamina K. La mayoría de los pacientes requieren un enfoque multidisciplinario y un tratamiento escalonado que incluye procedimientos radiológicos, como la aplicación de balones y stents y la inserción de shunts portosistémicos transyugulares intrahepáticos (TIPS), procedimien- tos quirúrgicos de descomprensión y, por último, trasplante hepático. 

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Biografía del autor/a

Simón Correa Gaviria
  1. Médico y cirujano de la Universidad de Antioquia. Integrante del Grupo de Gastrohepatología, Universidad de Antioquia. Estudiante de Master
    of Medical Sciences in Clinical Investigation de Harvard Medical School. Director de Promoción a la Investigación, Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia. Medellín, Colombia. 

Ana Catalina Ramírez
  1. Médica y cirujana, Universidad de Antioquia. Integrante del Grupo de Gastrohepatología de la Universidad de Antioquia. Medellín, Colombia. 

Yeinis Paola Espinoza Herrera
  1. Médica y cirujana, Universidad de Antioquia. Integrante del Grupo de Gastrohepatología de la Universidad de Antioquia. Medellín, Colombia 

Juan Carlos Restrepo Gutiérrez
Médico general, especialista en Medicina interna, subespecialista en Hepatología clínica y trasplante de hígado. Magíster en Trasplante de órganos y tejidos. Doctor en Hepatología. Integrante del Grupo de Gastrohepatología de la Universidad de Antioquia. Médico Internista del Grupo de Hepatología y trasplante de hígado del Hospital Pablo Tobón Uribe. Profesor de la Facultad de Medicina de la Universidad de Antioquia. Medellín, Colombia.

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Publicado
2017-02-16
Cómo citar
Correa Gaviria, S., Ramírez, A. C., Espinoza Herrera, Y. P., & Restrepo GutiérrezJ. C. (2017). Síndrome de Budd Chiari: revisión de tema. Revista Colombiana De Gastroenterología, 31(3), 242-252. https://doi.org/10.22516/25007440.97
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Revisión de tema

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