Medicine (MD/DO)
Hepatic Disorders
Budd-Chiari Syndrome

Master Budd-Chiari Syndrome with Picmonic for Medicine

With Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing.

Budd-Chiari Syndrome

Recommended Picmonics

picmonic thumbnail
Hepatitis A
picmonic thumbnail
Hepatitis A (HAV) Assessment
picmonic thumbnail
Hepatitis B (HBV) Assessment
picmonic thumbnail
Hepatitis B Virus Disease
picmonic thumbnail
Hepatitis C

Budd-Chiari Syndrome

Budd-Chiari syndrome is a rare hepatic disorder of obstructed venous outflow from the hepatic veins. Patients develop hepatomegaly with centrilobular congestion and necrosis of the liver. Patients can develop ascites, abdominal pain, and on gross pathology have a "nutmeg liver." Causes for this syndrome include tumor, chronic infection, hematologic disorders, along with pregnancy and postpartum changes.
Pregnancy and Postpartum
Pregnant-woman and Post-baby

Budd-Chiari syndrome is also associated with pregnancy, along with the postpartum state in females.

Hematologic Disorders
He-man-blood Disordered

Hematologic disorders such as polycythemia vera, paroxysmal nocturnal hemoglobinuria, antiphospholipid antibody syndrome, and essential thrombocytosis are possible causes. Other inherited coagulopathies include the following: Protein C deficiency, Protein S deficiency, Antithrombin III deficiency and Factor V Leiden. Hypercoagulability can lead to hepatic venous thrombosis.


Tumors or metastatic disease; specifically hepatocellular carcinoma (HCC), renal cell carcinoma, leiomyosarcoma, adrenal carcinoma, Wilms' tumor and right atrial myxoma are associated with Budd-Chiari. Tumors can cause hepatic venous outflow obstruction via mechanical obstruction and compression of the IVC. Furthermore, cancer can lead to a hypercoagulable state, which can also lead to a predisposition for thrombosis.

Chronic Infections
Crone with Infectious bacteria and viruses

Chronic infections can predispose patients to developing Budd-Chiari syndrome. Specific examples include hydatid cysts, aspergillosis, amebic abscesses, syphilis, and tuberculosis.

Thrombosis of Major Hepatic Veins
Trombones in Major Hepatic Vein

The most common pathophysiology for this syndrome is thrombosis of the major hepatic veins, preventing venous flow from leaving the liver. This does not always have to be a thrombotic cause, and mechanical obstruction can also lead to this syndrome.

Centrilobular Congestion and Necrosis
Centrilobular Congested-traffic and Necrosis-crows

When venous flow of the liver is compromised, the liver becomes enlarged and the sinusoids are engorged with blood. There is centrilobular congestion, and decreased oxygen transport leads to tissue necrosis.

Abdominal Pain
Abdominal Pain-bolt

Patients can complain of abdominal pain with this disorder.

Ascites Iced-tea

Ascites is a common feature of Budd-Chiari syndrome. This occurs because of two different pathophysiologies. As venous flow is backed up, lower extremity edema forms. Later in the course of disease, when liver damage occurs, albumin production decreases. This decreases vascular osmotic pressure, allowing fluids to third-space into tissues.


Patients display hepatomegaly on exam with Budd-Chiari syndrome, and elevated liver enzymes may be seen. This may correlate to other hepatic disorders, like liver failure, encephalopathy.

Nutmeg Liver

"Nutmeg liver" is a description of the gross appearance of the liver with chronic Budd-Chiari syndrome. This term describes the mottled, dark red congested regions that represent accumulation of RBC's in centrilobular regions on gross pathology.


Take the Budd-Chiari Syndrome Quiz

Picmonic's rapid review multiple-choice quiz allows you to assess your knowledge.

It's worth every penny

Our Story Mnemonics Increase Mastery and Retention

Memorize facts with phonetic mnemonics

Unforgettable characters with concise but impactful videos (2-4 min each)

Memorize facts with phonetic mnemonics

Ace Your Medicine (MD/DO) Classes & Exams with Picmonic:

Over 1,890,000 students use Picmonic’s picture mnemonics to improve knowledge, retention, and exam performance.

Choose the #1 Medicine (MD/DO) student study app.

Picmonic for Medicine (MD/DO) covers information that is relevant to your entire Medicine (MD/DO) education. Whether you’re studying for your classes or getting ready to conquer the USMLE Step 1, USMLE Step 2 CK, COMLEX Level 1, or COMLEX Level 2, we’re here to help.

Works better than traditional Medicine (MD/DO) flashcards.

Research shows that students who use Picmonic see a 331% improvement in memory retention and a 50% improvement in test scores.