Beyond the Clot: A Case-based Exploration of Advanced Nursing and Medical Care Insights from Budd–Chiari Syndrome

Abstract

Introduction and Objectives

This case highlights advanced nursing care in a 30-year-old male with rare and complex Budd–Chiari Syndrome (BCS) due to hepatic venous outflow tract obstruction. It emphasises the role of early detection and continuous nursing management in preventing complications such as portal hypertension and liver failure.

Nursing Assessment

Using Virginia Henderson’s 14 basic needs, the patient was assessed as unconscious, ventilator-dependent, with renal dysfunction, pedal oedema, severe jaundice and ascites.

Intervention

The patient underwent transjugular intrahepatic portosystemic shunt in 2023, followed by inferior vena cava venoplasty and direct intrahepatic portosystemic shunt. On readmission in April 2025, conservative management with ventilator support, antibiotics, anticonvulsants and nutritional supplementation was initiated. Nursing care, guided by NANDA and NIC, focused on airway management, fluid-electrolyte balance, bleeding precautions, infection prevention and family support.

Conclusion

This case underscores the need for integrated medical and nursing care in BCS, where advanced interventions and evidence-based nursing, guided by Virginia Henderson’s model and NANDA–NIC, support early detection, continuous monitoring and collaborative management to improve outcomes.