Multidisciplinary collaboration successfully treated Budd Chiari syndrome complicated with hepatocellular carcinoma rupture and bleeding: A case report.

[RATIONALE] Budd-Chiari syndrome (BCS) complicated by ruptured hepatocellular carcinoma (HCC) is relatively uncommon. This case underscores the critical role of multimodal imaging and interdisciplinary collaboration.

[PATIENT CONCERNS] A 46-year-old female presented with abdominal pain for 10 + days, aggravated for 5 hours. the emergency abdominal enhanced computed tomography: malignant space occupying in the left inner lobe of liver (HCC is possible) and hematocele in abdominal cavity. Magnetic resonance imaging enhancement of the upper abdomen was performed: malignant mass of the left lobe of the liver with hemorrhage and necrosis, compensatory enlargement of the right lobe of the liver, unclear display of hepatic veins, and stenosis of the hepatic segment of the inferior vena cava, which was consistent with Budd-Chiari syndrome.

[DIAGNOSES] Budd-Chiari syndrome with hepatocellular carcinoma rupture and bleeding.

[INTERVENTIONS] Interventional therapy, surgical treatment.

[OUTCOMES] Hepatic venous outflow obstruction was successfully relieved by interventional therapy combined with surgery and tumor resection was performed. After 39 days of intensive care, the patient improved and was discharged smoothly.

[LESSONS] For patients with Budd-Chiari syndrome and hepatocellular carcinoma, the Multidisciplinary diagnosis and treatment (MDT) model should be implemented throughout the entire treatment process. Through the MDT model, personalized treatment plans can be developed, combining various methods to relieve liver vein outflow obstruction and remove tumors, while also establishing appropriate treatment measures and processes, thereby improving treatment outcomes and reducing the risk of complications and disease progression. However, within the MDT model, different physicians must propose treatment plans based on their professional knowledge and the specific circumstances of each patient. In the process of personalized treatment, issues such as how to balance pros and cons and select the optimal solution also present challenges to clinical practitioners.