# Budd-Chiari syndrome in a 33-year-old woman with hypercoagulable state: A case report

## TL;DR

A 33-year-old woman with a hypercoagulable state developed Budd-Chiari syndrome, highlighting the need for early diagnosis and evaluation of clotting disorders.

## Contribution

This case report adds to the understanding of BCS by linking it to multiple protein deficiencies and complex comorbidities.

## Key findings

- BCS was diagnosed using Doppler ultrasound and contrast-enhanced CT in a patient with protein deficiencies.
- The patient's poor prognosis was due to recurrent ascites and behavioral issues despite anticoagulation.
- Early recognition and evaluation of prothrombotic conditions are critical for better BCS outcomes.

## Abstract

Budd-Chiari syndrome (BCS) is a rare disorder caused by hepatic venous outflow obstruction, often linked to underlying prothrombotic conditions. This case describes a 33-year-old woman who presented with abdominal pain and ascites and was diagnosed with BCS secondary to deficiencies in protein C, protein S, and antithrombin III. She also had a history of epilepsy, bipolar disorder, and poor medication adherence. Imaging studies, including Doppler ultrasound and contrast-enhanced CT, played a crucial role in confirming the diagnosis. Despite treatment with anticoagulation and diuretics, recurrent ascites and behavioral issues complicated management, leading to a poor prognosis. This case highlights the importance of early recognition, imaging in diagnosis, and evaluation of prothrombotic disorders in patients with BCS to improve outcomes.