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Budd-Chiari syndrome — SCE Acute Medicine MCQ

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ModerateAcute GI PresentationsBudd-Chiari syndromeSCE Acute Medicine

A 34-year-old woman is assessed on the acute medical unit. She has abdominal pain, tender hepatomegaly and ascites while taking oestrogen therapy. Doppler ultrasound shows hepatic vein thrombosis. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: D — Budd-Chiari syndrome

Budd-Chiari syndrome is the best answer because hepatic venous outflow obstruction with painful hepatomegaly and ascites is Budd-Chiari syndrome. Anaphylaxis is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Screen for myeloproliferative disease in apparently unprovoked cases.

Reference: BSG vascular liver disease guidance