Buerger’s syndrome – Buerger’s syndrome was first discovered and named after the French doctor Bourgogne in the early 20th century. It is a disease of vascular origin. It is a rare and difficult disease that is often misdiagnosed and mistreated because of its lack of specific symptoms, and it has been called the “sister” disease of hepatitis because its clinical symptoms and their regression resemble post-hepatitis cirrhosis. The misdiagnosis and mistreatment rate of this disease is quite high, according to statistics, the misdiagnosis rate of this disease is as high as 83.6%. Some even treat it as hepatitis cirrhosis for decades. Others diagnose it as nephritis, pericarditis, peritonitis, and a few are also misdiagnosed as saphenous varicose vein, spermatic varicose vein and done surgery, bringing unnecessary pain to the patients. Although the symptoms of Buga syndrome and hepatitis are very similar, the former is more symptomatic while the liver function damage is often less severe. In addition, the pathogenesis and treatment of the two are very different, so they can still be differentiated. For example, hepatitis is caused by viral infection to the liver, resulting in liver cell damage, which needs to rely on medication; while Buga’s syndrome is caused by obstruction of hepatic and inferior vena cava return, stasis and swelling in the liver, resulting in liver cell damage, which needs to rely on intervention or surgery to lift the obstruction of venous blood return to get effective treatment. The syndrome is characterized by a high incidence in young and middle-aged people, a high incidence in men, and simultaneous obstruction of the liver and the inferior vena cava. After the disease, the pressure of both the liver and the inferior vena cava is elevated, which can be two times higher than normal. Therefore, the main points of diagnosis are: “one black” – skin pigmentation of lower limbs, “two large” – stasis of liver and spleen enlargement, “three varicose” – thoracic and abdominal wall veins, spermatic vein, saphenous vein varicose, “two more” – The liver ultrasound examination is non-invasive. Ultrasound examination of the liver is the earliest and fastest way to detect the disease, so it is called the “outpost examination”. Inferior vena cava angiography is the “gold standard” for diagnosis and differentiation of the type, and provides a good basis for designing a treatment plan. Asymptomatic: Hepatic vein thrombosis without obvious circulatory disturbances, only incidentally detected during hepatic venography and ultrasound. Acute type: Acute onset, severe epigastric pain, nausea, vomiting, ascites, jaundice and hepatomegaly, and death may occur within a short period of time. Chronic type: slow onset and progression, with gradual onset of abdominal distension, discomfort in the liver area, vague pain and hepatomegaly, leading to hepatic sclerosis, splenomegaly, ascites and gastrointestinal bleeding after many years. Buga’s syndrome – Treatment Acute type of hepatic veno-occlusive disease, if caused by thrombosis, should be treated with early anticoagulation. For hepatic segmental inferior vena cava obstruction, inferior right atrial bypass can be considered, and incomplete obstruction can be treated surgically or interventionally, such as intracavitary angioplasty with balloon catheter or balloon dilated stent placement. For surgical treatment, depending on the condition, portal vein dissection, splenectomy, splenorenal vein shunt, etc. are performed to reduce portal vein pressure and cure hypersplenism. In conclusion, traditional surgery is not only traumatic and slow to recover, but also complex and risky because it is performed on large blood vessels. Therefore, in recent years, interventional therapy has become the treatment of choice for Buga’s syndrome. As for the success rate of this surgery, I should say that the doctor should have certainty in order to carry out the treatment for you, of course, there are risks in doing the surgery, and each patient has its own special characteristics, so you’d better go to a hospital with better conditions and stronger technology.