Ruptured hepatocellular carcinoma in a child with Budd-Chiari syndrome

Background Hepatocellular carcinoma is an uncommon complication described in patients with Budd-Chiari syndrome. Case characteristics A 12-year-old boy with Budd- Chiari syndrome, who was earlier treated with Transjugular intrahepatic porto-systemic shunt (TIPS), presented with acute onset hemoperitoneum and hypotension. Outcome It was diagnosed to be a case of ruptured hepatocellular carcinoma. Message Successful TIPS may not prevent the development of hepatocellular carcinoma, and children with Budd Chiari syndrome should be monitored for the same.