Budd-Chiari syndrome involves occlusion of which vessels?

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Budd-Chiari syndrome is a hepatic venous outflow obstruction. The liver drains its blood through hepatic veins into the inferior vena cava, so when these veins are blocked, blood backs up in the liver, causing congestion, hepatomegaly, ascites, and liver dysfunction. This makes hepatic veins the defining vessels involved. The portal vein brings blood into the liver (inflow) and is not the site of the obstruction in Budd-Chiari; the hepatic artery supplies arterial blood, and occlusion there causes different issues unrelated to this syndrome. In practice, Budd-Chiari is most often due to thrombosis or obstruction of the hepatic veins, with the IVC near the hepatic veins sometimes involved, but the key target is the hepatic venous outflow.