Differential diagnosis

Sinusoidal obstructive

syndrome

Usually occurs with recent (20 days) bone marrow transplant.

According to Seattle criteria 2 out of 3:

• Hepatomegaly

• Bilirubin > 2 mg/dl

• 2% Weight gain (fluid accumulation)

liver biopsy:

Budd Chiari syndrome

• Should be suspected in patient with

personal or family history of

thrombophilia presenting with classic

triad of abdominal pains, ascites and

hepatomegaly

• Doppler ultrasonography is considered

1st line investigation of choice in such

patients.

Congestive hepatopathy

• History of exertional dyspnea,

orthopnea and chest pain

• Jugular venous distension, cardiac

murmurs, tender hepatomegaly.

• Splenomegaly is uncommon

• Echocardiogram: dilated chambers or

impaired functions

Constrictive pericarditis

• History of TB, cardiac surgery, viral or

bacterial infections, dialysis and

systemic autoimmune disorders

• Jugular venous distension, Kussmaul

sign and pericardial rub

• ECG: low voltage

• ECHO: Pericardial thickening and

effusion

Atrial myxoma

• Systolic murmur with tumor plop

• ECHO: atrial mass seen

Thank you