investigations
Last reviewed 05/2021
These include:
- chest X-ray - enlarged azygous vein may be seen when there is caval obstruction
- liver biopsy - characteristic histology with dilated central veins and sinusoids; pericentral necrosis; replacement of hepatocytes by red blood cells; or, lately, centrilobular fibrosis
- ultrasound or CT scan - demonstrates hepatic vein occlusion with ascites
- sampling of ascitic fluid - high protein content
- liver isotopic scanning - except in patients with membranous obstruction of the vena cava - demonstrates absent function through most of the liver except for the caudate lobe which has a different drainage (directly to the vena cava through multiple small tributaries).
- venography - demonstrates hepatic vein occlusion, often with a beak-like deformity at their orifice