Advances and Challenges in Budd-Chiari Syndrome Management: A Review of the Literature

Darius Hartanto (Department of Internal Medicine, Indra Medical Centre Hospital, West Java, Indonesia)
Jeanne Winarta (Division of Gastroenterology-Hepatology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia)
Andrew Waleleng (Division of Gastroenterology-Hepatology, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia)

The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Vol 27, No 2 (2026): VOLUME 27, NUMBER 2, August, 2026

Budd-Chiari syndrome (BCS) is a medical condition caused by a partial or complete obstruction of hepatic venous outflow. Epidemiologically, BCS was considered rare, and its infrequent diagnosis was attributed to limited diagnostic tools and low clinical awareness. Therefore, this review aimed to enhance clinicians' awareness, from accurate diagnosis to appropriate management of patients with BCS. The symptoms experienced by patients ranged from asymptomatic cases to fulminant forms of the disease. Imaging methods, such as Doppler ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), were often used to establish the diagnosis. The primary treatment for BCS included anticoagulants, typically warfarin or low-molecular-weight heparin (LMWH). Depending on the patient's clinical status, more invasive therapeutic interventions could also be necessary.