Teenager with abdominal pain

CT of Budd Chiari syndrome
Axial (above) and coronal (below left) CT with contrast of the abdomen in the portal venous phase show heterogenous enhancement of the liver due to hepatic congestion. Coronal CT MIP (below right) suggests a narrowing of the inferior vena cava just below the cavoatrial junction. US (not provided) showed a web at this level in the inferior vena cava and a thrombus in the left hepatic vein.

The diagnosis was Budd Chiari syndrome.