Budd-Chiari syndrome with extensive portal thrombosis: treatment with Senning's procedure.

A patient with Budd-Chiari syndrome and associated extensive portal thrombosis, precluding any kind of portosystemic shunt, was treated with Senning's procedure. This technique, which includes dorsocranial hepatic resection and direct hepatoatrial anastomosis under total vascular exclusion of the liver, resulted in prompt recovery from acute hepatic failure and esophageal bleeding. Peroperatively, the hemodynamic status was secured with a venous cavo-caval bypass. This observation suggests that Senning's procedure is strongly indicated in the case of Budd-Chiari syndrome with extensive portal thrombosis.