Budd-Chiari syndrome on computed tomography scan

Computed tomography (CT) scan through the liver of a 17-year-old male with new onset abdominal distension shows a mottled appearance to the underperfused liver with collapsed portal veins, ascites (small arrows), and extensive retroperitoneal varices (large arrow). Note also the enlarged caudate lobe of the liver (large arrowhead) and the collapsed small inferior vena cava (small arrowhead). These are all characteristic imaging features of the Budd-Chiari syndrome.