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Budd‐Chiari syndrome (BCS) is caused by hepatic venous outflow obstruction. This work aimed at analyzing characteristics and factors associated with development of hepatocellular carcinoma (HCC) in patients with primary BCS.

A total of 348 Egyptian BCS patients were included. They were presented to the Budd‐Chiari Study Group of Ain Shams University Hospital. BCS was confirmed using abdominal Doppler US. Abdominal magnetic resonance imaging (MRI), MR venography and/or multislice computed tomography (CT) were performed to confirm all diagnoses and to assess vascular anatomy. Hepatic focal lesions detected during the study period (2005–2011) were evaluated using serum alpha foetoprotein (AFP) level, imaging features and histopathological examination.

Diagnosis of HCC was confirmed in 15/348 patients (4.3%). Imaging studies showed that 60 …