BCS can appear or ‘present’ as an acute condition which develops rapidly with the following symptoms:
- abdominal pain in the upper right hand side of your abdomen (referred to as the ‘upper right quadrant’)
- an enlarged liver due to the build-up of blood (hepatomegaly)
- swelling of legs and ankles
- cramp in legs and feet
More commonly, BCS can develop in a chronic form, where people are likely to have long-standing ascites and an enlarged liver (hepatomegaly). Very rarely, there is a fulminant form. This is a type of disease with a sudden and severe onset. In fulminant BCS, ascites, hepatomegaly and kidney failure can occur with rapid liver failure. Ascites are present in the majority of people because of portal hypertension
Like many liver diseases the symptoms of BCS are non-specific, meaning that they can be caused by many conditions other than BCS. Methods of diagnosis include liver function tests (LFTs) and imaging tests with ultrasound and computerised tomography (CT)
Ultrasound, the same technology used in pregnancy, directs sound waves through your skin via a probe device as it is passed over your liver area. Anything solid will bounce back as a reflected sound wave via the probe and will be turned into an image that can be seen on a screen. In BCS, a type of scan known as ‘Doppler’ ultrasound is used to obtain information about blood flow in your arteries and veins and this often gives enough information for BCS to be diagnosed.
A CT scan may also be used. This can obtain pictures, called tomograms, from different angles around your body using computer processing and can also show ‘cross-sections’ of your tissue and organs. This scan can show an enlargement of the liver and changes in the density (thickness) of liver tissue due to abnormal blood flow. A liver biopsy may not be necessary if other tests have helped doctors to identify the reason for liver problems.