# A rare pediatric case: Budd-Chiari Syndrome and upper gastrointestinal bleeding in a 5-year-old boy

## TL;DR

A rare case of Budd-Chiari Syndrome in a 5-year-old boy highlights challenges in diagnosis and treatment in resource-limited settings.

## Contribution

This case report adds to the limited literature on pediatric Budd-Chiari Syndrome and emphasizes the impact of financial barriers on treatment access.

## Key findings

- The case demonstrates the diagnostic difficulty of BCS due to atypical symptoms in children.
- Financial constraints hindered access to critical treatment (TIPS), underscoring healthcare disparities.
- Multidisciplinary care and early intervention are crucial for managing BCS and preventing complications.

## Abstract

Budd-Chiari Syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction, often presenting with ascites, hepatomegaly, and abdominal pain. The diagnosis and management of BCS, especially in resource-limited settings, pose significant challenges that can lead to poor patient outcomes.

This case report describes a previously healthy individual presenting with progressive abdominal distention, hematemesis, and right upper quadrant pain. The patient had a history of trauma and underwent subsequent percutaneous drainage for ascites. Imaging studies revealed non-opacified hepatic veins, splenomegaly, ascites, and a “nutmeg liver” pattern, confirming the diagnosis of BCS. The patient received blood transfusions, diuretics, and nutritional support. A Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure was planned but ultimately hindered by financial constraints.

This case highlights the challenges of managing BCS in resource-limited settings, particularly regarding access to specialized treatments like TIPS. It emphasizes the need for early diagnosis, multidisciplinary care, and the development of cost-effective treatment strategies to improve patient outcomes.

The management of Budd-Chiari Syndrome is complex, particularly in settings with limited resources. This case underscores the importance of timely intervention and the need for innovative approaches to healthcare delivery that can accommodate financial barriers while ensuring patient safety and care quality.

•Rare Case Presentation: The case report describes a patient with Budd-Chiari Syndrome (BCS), a rare condition affecting hepatic venous outflow. This case underscores the importance of recognizing this rare entity in clinical practice.•Challenges of Diagnosis: The patient's initial presentation was atypical, highlighting the diagnostic challenges associated with BCS, especially in resource-limited settings.•Impact of Resource Limitations: The case highlights the significant impact of financial constraints on accessing essential treatments like TIPS, emphasizing the need for improved healthcare access in resource-limited environments.•Multidisciplinary Approach: The patient's care required a multidisciplinary approach, involving various specialists and interventions. This underscores the importance of collaboration in managing complex medical conditions.•Importance of Early Intervention: The patient's recurrent complications highlight the significance of early diagnosis and timely interventions for optimal outcomes in BCS management.

Rare Case Presentation: The case report describes a patient with Budd-Chiari Syndrome (BCS), a rare condition affecting hepatic venous outflow. This case underscores the importance of recognizing this rare entity in clinical practice.

Challenges of Diagnosis: The patient's initial presentation was atypical, highlighting the diagnostic challenges associated with BCS, especially in resource-limited settings.

Impact of Resource Limitations: The case highlights the significant impact of financial constraints on accessing essential treatments like TIPS, emphasizing the need for improved healthcare access in resource-limited environments.

Multidisciplinary Approach: The patient's care required a multidisciplinary approach, involving various specialists and interventions. This underscores the importance of collaboration in managing complex medical conditions.

Importance of Early Intervention: The patient's recurrent complications highlight the significance of early diagnosis and timely interventions for optimal outcomes in BCS management.