OCCLUSION OF THE HEPATIC VEINS

Abstract

Occlusion of the hepatic veins apparently may be caused by disease of the veins themselves or may occur secondarily to inflammatory, cirrhotic or neoplastic changes in the liver, thrombosis in the neighboring vena cava, polycythemia vera or debilitating disease in which the circulation is slowed. The obstruction is usually due to thrombosis, but some investigators have expressed the view that it is developmental. Occlusion of the hepatic veins leads to congestion and atrophy of the liver. Usually the region of congestion is not large enough to produce recognizable symptoms. If symptoms do arise they usually are masked by the more profound changes of the primary disease. Rarely, the process is sufficiently disturbing and encompassing to produce portal hypertension and even hepatic failure. The syndrome may develop slowly or rapidly. The outstanding clinical features are pain in the upper part of the abdomen and the back, an enlarged tender liver with