<prompt> The obstruction of two or more major hepatic veins is seen in:Budd-Chiari syndromeReyes syndromeRotor syndromeCrigler-Najjar syndrome  <response>: A. Budd-Chiari syndromeRef: Nelsons 20e p 1973, Ghai 8e p 320Budd-Chiari Syndrome: pg 388What is it?Portal hypertension caused by obstruction to hepatic veins anywhere between the efferent hepatic veins the entry of the inferior vena cava into the right atriumEtiology Hypercoagulable states e.g. antithrombin III deficiency, protein C or S deficiency, factor V Leiden or prothrombin mutations, paroxysmal nocturnal hemoglobinemia Hepatic or metastatic neoplasms, Collagen vascular disease, Infection, Trauma 