Presenter: Mounika
Bazar
Affiliation: Kanchi
Kamakoti Child's Trust Hospital, India
Presentation Type: Oral Presentation (Virtual)
Title: Budd–chiari syndrome as an
extraintestinal manifestation of ulcerative colitis in a child
🧠
Understanding the Association
Ulcerative
colitis
(UC) is a chronic
inflammatory bowel disease known for multiple extraintestinal manifestations.
Although hepatic involvement can occur, Budd–Chiari
syndrome (BCS)
is an exceptionally rare and potentially life-threatening complication in
children. BCS results from obstruction of hepatic venous outflow and may remain
clinically silent until advanced liver disease develops.
👦 The Clinical Story
We report the case of a
12-year-old boy diagnosed with UC after colonoscopy and histopathological
confirmation of pancolitis.
He was initially treated with:
·
💉 Intravenous corticosteroids
·
💊 Oral steroids
·
🌿 Mesalamine
·
🧬
Azathioprine
The child showed good symptomatic improvement
and entered clinical remission.
🔍 An Unexpected Finding
During routine follow-up one year
later, abdominal ultrasonography revealed coarse liver echotexture and
nodularity—despite:
·
✅
Normal liver function tests
·
✅
Normal coagulation profile
This prompted further evaluation
with liver biopsy, contrast-enhanced CT scan, and Doppler studies.
🧪
Diagnostic Confirmation
Liver biopsy demonstrated
cirrhosis characterized by lobular distortion, sinusoidal dilatation, and
venous intimal fibrosis.
Imaging findings included:
·
Hepatomegaly
·
Caudate
lobe hypertrophy
·
Narrowing
of intrahepatic inferior vena cava and hepatic veins
·
Collateral
vessel formation
These features confirmed chronic Budd–Chiari syndrome.
A detailed hypercoagulable work-up
was negative, except for low-titer ANA positivity.
🩺
Management & Outcome
The child was diagnosed with
compensated cirrhosis and started on anticoagulation therapy.
Interventional radiology-guided
angioplasty was successfully performed to relieve venous obstruction. He
remains stable under close multidisciplinary follow-up involving pediatric
gastroenterology, hepatology, and radiology teams.
🌟 Key Takeaways
·
BCS is
a rare but serious extraintestinal manifestation of Ulcerative colitis in children.
·
Subtle
imaging abnormalities may precede biochemical derangements.
·
Early
Doppler evaluation is essential even when liver function tests are normal.
·
Prompt
multidisciplinary intervention can prevent progression to hepatic
decompensation.
👩⚕️ About the Speaker
Dr. Mounika Bazar, from
India, has completed advanced training in Pediatric Gastroenterology,
Hepatology, and Nutrition and is actively engaged in clinical practice and
academic work. She has presented her research at national and international
conferences and contributes to academic writing and clinical research. Her work
reflects a commitment to academic excellence, with an evolving focus on
healthcare systems, quality improvement, and medical education.
🌍 Join the Global Conversation
Event:
International Conference on Pediatrics, Neonatology & Child Health
📅 March
26–28, 2026
📍 Singapore
& Online
🔗 Website: https://pediatrics.miconferences.com/
🔗 Register: https://pediatrics.miconferences.com/register
🔗 Abstract
Submission: https://pediatrics.miconferences.com/abstract-submission
📞 Phone: +1 (312) 462-4448
💬 WhatsApp: +1 (424) 377-0967
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