Hepatic venoocclusive disease is a rare cause of hepatic congestion. It is characterised by subendothelial sclerosis with thickening and obliteration of the terminal venules and sinusoids of the liver in the absence of fibrin thrombi or other causes of venous outflow obstruction.
It was initially described following the ingestion of herbal teas containing pyrrolizidine alcohols. More recently, it has been associated with radiotherapy and with the use of immunosuppressants in recipients of renal and bone marrow transplants. These agents are thought to damage the endothelium.
The sclerosed veins may undergo thrombosis that may extend into the major outflow veins approximating the Budd-Chiari syndrome.
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