{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:35:01Z","timestamp":1786977301526,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Budd\u2010Chiari syndrome (BCS) is an uncommon but potentially life\u2010threatening hepatic vascular disorder resulting from obstruction of the hepatic venous outflow. While it predominantly affects adults, pediatric and adolescent presentations are rare, particularly those associated with inherited thrombophilia. Early diagnosis and appropriate intervention are essential to prevent complications such as portal hypertension, hepatic ischemia, and liver failure. We describe the case of a 15\u2010year\u2010old female who presented with progressive abdominal distension, right upper quadrant pain, and bilateral lower limb edema. Imaging studies, including ultrasound and contrast\u2010enhanced CT, revealed hepatic venous obstruction with thrombus extension into the portal, superior mesenteric and splenic veins, and gross ascites. Laboratory findings indicated elevated inflammatory markers and impaired liver function. A detailed thrombophilia workup demonstrated deficiencies in protein C and antithrombin III and a Factor V Leiden mutation, confirming a hypercoagulable state as the underlying etiology. The patient was diagnosed with subacute Budd\u2010Chiari Syndrome secondary to inherited thrombophilia. She was initiated on anticoagulation therapy with warfarin, later transitioned to rivaroxaban, and managed with diuretics and dietary modifications. Clinical improvement was achieved, and the patient was referred to a liver transplant center for ongoing evaluation.<\/jats:p>","DOI":"10.1002\/ccr3.71606","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T03:45:42Z","timestamp":1765511142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual Etiology of Budd\u2010Chiari Syndrome in an Adolescent: A Case of Combined Thrombophilic Disorder"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9045-0683","authenticated-orcid":false,"given":"Santosh","family":"Sah","sequence":"first","affiliation":[{"name":"Internal Medicine Dow University of Health Sciences (DUHS)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumaisa","family":"Riaz","sequence":"additional","affiliation":[{"name":"Internal Medicine Dow University of Health Sciences (DUHS)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsheen","family":"Khan","sequence":"additional","affiliation":[{"name":"Internal Medicine Dow University of Health Sciences (DUHS)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5229-3448","authenticated-orcid":false,"given":"Tularam","family":"Yadav","sequence":"additional","affiliation":[{"name":"Primary Healthcare Centre (PHCC) Jhorahat  Gramthan Koshi Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirshan","family":"Lal","sequence":"additional","affiliation":[{"name":"Internal Medicine Dow University of Health Sciences (DUHS)  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8032-7462","authenticated-orcid":false,"given":"Hussain Haider","family":"Shah","sequence":"additional","affiliation":[{"name":"Internal Medicine Dow University of Health Sciences 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