This study is a single-center, retrospective, descriptive analysis of patients diagnosed with Budd-Chiari syndrome (BCS) in our clinic over a nine-year period (July 2015–July 2024). A total of 30 patients (aged 18–74 years) were included, with a male-to-female ratio of 11:19.

All patients underwent comprehensive imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), to assess hepatic involvement and vascular disease. Imaging findings were analyzed to classify cases based on common (such as hepatic vein thrombosis, collateral circulation, parenchymal changes, and enhancement patterns) and specific BCS features.

Definition: Budd-Chiari syndrome (BCS) refers to hepatic venous outflow obstruction, occurring anywhere from the small hepatic veins to the junction of the inferior vena cava and the right atrium, regardless of the underlying cause [1].

Clinical: BCS manifestations range from mild symptoms to fulminant liver failure or chronic disease. Clinical presentation depends on the extent of hepatic venous obstruction and the efficiency of primary and collateral venous outflow [2].

BCS is categorized based on etiology, obstruction location, and disease duration (acute, subacute, or chronic).

Etiology:

• • Primary BCS: Caused by endoluminal venous lesions (e.g., thrombosis or vascular wall disease).
  • Secondary BCS: Due to external compression (e.g., tumors), hematological or autoimmune diseases, oral contraceptive use, or trauma [1,3].
  • Congenital BCS: Associated with agenesis of the inferior vena cava or hepatic veins.