Hepatic Caudate Lobe Venous Drainage

Anatomical Characteristics of the Caudate Lobe

The hepatic caudate lobe has a distinctive anatomical characteristic that allows for compensatory hypertrophy in cases of hepatic vein obstruction, with separate venous drainage directly into the inferior vena cava through multiple short hepatic veins 1, 2, 3

In cases of Budd-Chiari syndrome, the caudate lobe typically undergoes hypertrophy due to its separate venous drainage into the IVC, allowing for sparing of outflow when other hepatic veins are obstructed, found in about 75% of patients 1, 2, 3, 4
This compensatory hypertrophy of the caudate lobe can cause narrowing of the intrahepatic portion of the IVC in patients with pure hepatic vein thrombosis 2, 3
Imaging studies in patients with Budd-Chiari syndrome often show early homogeneous enhancement of the caudate lobe following contrast administration, while the periphery of the liver shows delayed patchy enhancement 4, 5