Abstract
Budd-Chiari syndrome consists a rare medical entity which has an estimated incidence of 0.1 to 10 people per million every year. It is defined by the obstruction of the flow in the inferior vena cava or the hepatic veins. Various classifications have been proposed. So, it can be acute or chronic and primary or secondary. Iatrogenic, a subtype of secondary Budd-Chiari syndrome, is caused by various medical interventions, including liver transplantation. On the other hand, liver transplantation is the ultimate therapeutic management of Budd-Chiari syndrome. Finally, a medical paradox and a vicious circle has been created. Liver transplantation can potentially be both the cause and treatment of Budd-Chiari syndrome. Budd-Chiari syndrome is simultaneously the cause and complication of liver transplantation. Our aim is to describe this double role of liver transplantation in Budd-Chiari syndrome and to acknowledge that a high degree of clinical suspicion is necessary for the proper recognition and management of this life-threatening condition.