In Budd-Chiari syndrome, the liver is swollen and red-purple and has a tense
capsule.
• Microscopically, the affected hepatic parenchyma reveals severe centrilobular
congestion and necrosis.
• Centrilobular fibrosis develops in instances in which the thrombosis is more
slowly developing.
• The major veins may contain fresh occlusive thrombi or, in chronic cases,
organized adherent thrombi.
• The mortality of untreated acute hepatic vein thrombosis is high.
• The chronic form is far less lethal, and more than two-thirds of patients are alive
after 0 years.