Advisability of surgical treatment for chronic membranous obstruction of the hepatic portion of the inferior vena cava.

Transatrial membranotomy was performed in a patient with membranous obstruction of the hepatic segment of the inferior vena cava, manifesting as longstanding varicosity and edema of the legs, chronic type of Budd-Chiari syndrome, liver cirrhosis and hypersplenism. The course in this patient and similar ones reported in the literature suggests a conservative approach.