A 62-year-old man, who had experienced temporary relief for approximately 2 weeks from the symptoms of fever, fatigue and abdominal distension after treatment with oral antibiotics and anti-inflammatory medication at a nearby hospital, was referred to our hospital for recurrence of symptoms that did not respond to conservative therapies. Upon admission, he was diagnosed with severe liver dysfunction. Contrast-enhanced computed tomography and angiography indicated occlusion of the hepatic venules. Transvenous liver biopsy specimens revealed the presence of hepatic veno-occlusive disease (HVOD) features. His liver function worsened rapidly thereafter and he died of ruptured esophageal varices after one and a half months of hospitalization. Hence, HVOD should be considered as a possible diagnosis in patients with ascites, jaundice, and painful hepatomegaly even in the absence of a history of stem cell transplant, chemotherapy, or radiation factors commonly associated with HVOD.
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