{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:05:54Z","timestamp":1791965154225,"version":"4.3.4"},"reference-count":11,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1995,1]]},"abstract":"<jats:p>Polycystic liver disease is commonly asymptomatic but may present with hepatomegaly, abdominal distension, and dull abdominal pain. Transudative ascites is a rare manifestation in these patients but may occur when portal hypertension is present resulting from associated hepatic fibrosis or after deroofing procedure of a cyst. Exudative ascites might suggest hepatic venous outflow obstruction. Four cases are described where hepatic venous outflow obstruction occurred in patients with polycystic liver disease. Three patients had orthotopic liver transplantation and one had a mesocaval shunt. Of the two patients that survived orthotopic liver transplantation both have shown considerable improvement in their symptoms. None of the patients had any confirmed procoagulant disorder. The mechanism of hepatic venous outflow obstruction in these patients seems to be mechanical compression of hepatic veins by the cysts and associated formation of thrombi in small hepatic vein tributaries. Patients with severe polycystic kidney\/liver disease are at risk of hepatic venous outflow obstruction and the onset of this complication is heralded by tender hepatomegaly and presence of exudative ascites.<\/jats:p>","DOI":"10.1136\/gut.36.1.142","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"142-145","source":"Crossref","is-referenced-by-count":65,"title":["Hepatic venous outflow obstruction in patients with polycystic liver disease: pathogenesis and treatment."],"prefix":"10.1136","volume":"36","author":[{"given":"W","family":"Uddin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J K","family":"Ramage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Portmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Benjamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K C","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1995,1,1]]},"reference":[{"key":"ref_1","article-title":"Human genetics: problems and approaches","author":"Vogel, F.; Motulsky, A.G.","unstructured":"Vogel F, Motulsky AG. Human genetics: problems and approaches. Berlin: Springer Verlag, 1986: 418."},{"key":"ref_2","first-page":"1","article-title":"Liver changes and complications in adult polycystic kidney disease","volume":"14","author":"Grunfield, J.P.","year":"1985","unstructured":"Grunfield JP. Liver changes and complications in adult polycystic kidney disease. Adv Nephrol 1985; 14: 1-20.","journal-title":"Adv Nephrol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/0002-9343(80)90266-1","article-title":"Liver cysts in patients with autosomal dominant polycystic kidney disease","volume":"68","author":"Milutinovic, J.; Failkon, P.J.; Rudd, T.G.","year":"1980","unstructured":"Milutinovic J, Failkon PJ, Rudd TG. Liver cysts in patients with autosomal dominant polycystic kidney disease. Am Jf Med 1980; 68: 741-3.","journal-title":"Am Jf Med"},{"key":"ref_4","first-page":"229","article-title":"Liver cysts in autosomal dominant polycystic kidney disease. Clinical and computerised tomographic study","volume":"145","author":"Levine, E.; Cook, L.T.; Grantham, J.J.","year":"1985","unstructured":"Levine E, Cook LT, Grantham JJ. Liver cysts in autosomal dominant polycystic kidney disease. Clinical and computerised tomographic study. Am _7 Roentgenol 1985; 145: 229-33.","journal-title":"Am"},{"key":"ref_5","first-page":"109","article-title":"Highly symptomatic adult polycystic disease of liver","volume":"5","author":"KJ, Van Erpecum; AR, Janssens; JL, Terpstra","year":"1987","unstructured":"Van Erpecum KJ, Janssens AR, Terpstra JL. Highly symptomatic adult polycystic disease of liver. _7 Hepatol 1987; 5:109-77."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1001\/archsurg.1990.01410170021003","article-title":"Liver transplantation for polycystic liver disease","volume":"125","author":"Starzl, T.E.; Reyes, J.; Tzakis, A.","year":"1990","unstructured":"Starzl TE, Reyes J, Tzakis A. Liver transplantation for polycystic liver disease. Arch Surg 1990; 125: 575-7.","journal-title":"Arch Surg"},{"key":"ref_7","first-page":"162","article-title":"Polycystic liver disease. Analysis of seventy cases","volume":"59","author":"Melnick, P.J.","year":"1955","unstructured":"Melnick PJ. Polycystic liver disease. Analysis of seventy cases. Arch Pathol 1955; 59: 162-72.","journal-title":"Arch Pathol"},{"issue":"131","key":"ref_8","first-page":"674","article-title":"Non parasitic cyst (congenital) of the liver with a study of aberrant bile ducts","volume":"1906","author":"Moschronitz, E.","unstructured":"Moschronitz E. Non parasitic cyst (congenital) of the liver with a study of aberrant bile ducts. Am.7 Med Sci 1906; 131: 674-99.","journal-title":"Am.7 Med Sci"},{"key":"ref_9","first-page":"41","article-title":"Bloc supra hepatique","author":"Valla, D.; Benhamou, J.P.","year":"1984","unstructured":"Valla D, Benhamou JP. Bloc supra hepatique. In: Benhamou JP, Lebree D, eds. Hypertension portale. Paris: Doireden, 1984: 41-56."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1002\/bjs.1800790629","article-title":"Clinical experience with adult polycystic liver disease","volume":"79","author":"Vauthey, J.-N.; Maddern, G.J.; Kolbinger, P.; Baer, H.V.; Blumgart, L.H.","year":"1992","unstructured":"Vauthey J-N, Maddern GJ, Kolbinger P, Baer HV, Blumgart LH. Clinical experience with adult polycystic liver disease. BrJ Surg 1992; 79: 562-5.","journal-title":"BrJ Surg"},{"key":"ref_11","first-page":"296","article-title":"Budd-Chiari syndrome in association with polycystic disease of the liver and kidneys","volume":"85","author":"Bhupalan, A.; Talbot, K.; Forbes, A.; Owen, M.; Samson, D.; Murray-Lyon, I.M.","year":"1992","unstructured":"Bhupalan A, Talbot K, Forbes A, Owen M, Samson D, Murray-Lyon IM. Budd-Chiari syndrome in association with polycystic disease of the liver and kidneys. Jf R Soc Med 1992; 85: 296-7.","journal-title":"Jf R Soc Med"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.36.1.142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T04:33:25Z","timestamp":1765600405000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.36.1.142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1995,1,1]]},"published-print":{"date-parts":[[1995,1]]}},"alternative-id":["10.1136\/gut.36.1.142"],"URL":"https:\/\/doi.org\/10.1136\/gut.36.1.142","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,1]]}}}