<prompt> A 25-year-old woman develops nausea, vomiting, and abdominal pain. On examination, she has tender hepatomegaly and ascites. She was recently started on oral contraceptives. The clinical diagnosis is?Budd-Chiari syndromeAcute viral hepatitisPortal hypertensionAcute cholecystitis  <response>: Ans. A Budd-Chiari syndromeRef: CMDT 2019 page 726Budd-Chiari syndrome occurs from thrombosis of the major hepatic veins and has been associated with oral contraceptives. The main diagnostic features are Right upper quadrant pain and tenderness Ascites Imaging studies show occlusionabsence of flow in the hepatic veins or inferior vena cava Clinical picture is similar in sinusoidal obstruction syndrome but major hepatic veins are patent. 