PT - JOURNAL ARTICLE AU - Camila C Simoes AU - Yezaz A Ghouri AU - Shehzad N Merwat AU - Heather L Stevenson TI - Budd-Chiari syndrome: a rare and life-threatening complication of Crohn’s disease AID - 10.1136/bcr-2017-222946 DP - 2018 Jan 17 TA - BMJ Case Reports PG - bcr-2017-222946 VI - 2018 4099 - http://casereports.bmj.com/content/2018/bcr-2017-222946.short 4100 - http://casereports.bmj.com/content/2018/bcr-2017-222946.full AB - Budd-Chiari syndrome (BCS) is characterised by obstruction of hepatic venous outflow and may be triggered by the prothrombotic state associated with inflammatory bowel disease (IBD). We reported a case of Crohn’s disease (CD) that presented with anasarca, ascites, symptomatic hepatomegaly, elevated liver enzymes, increased prothrombin time and low albumin. Oesophagogastroduodenoscopy and colonoscopy confirmed active CD. Abdominal CT showed hepatic vein thrombosis. Liver biopsy revealed severe perivenular sinusoidal dilation with areas of hepatocyte dropout, bands of hepatocyte atrophy and centrizonal fibrosis, suggestive of BCS. The patient was treated with steroids for CD and systemic anticoagulants for BCS. His liver function and enzymes normalised, and he reported symptomatic improvement. The precise mechanism responsible for increased hypercoagulability in IBD remains unclear. Early recognition and treatment for possible thrombotic complications of CD is critical to prevent potentially fatal events like pulmonary embolism or liver failure.