31st July 2023

A 25-year-old male presents with severe right upper quadrant pain and ascites

A 25-year-old male presents with severe right upper quadrant pain and ascites. A doppler ultrasound reveals Budd Chiari syndrome and anticoagulation is commenced. On closer questioning, the man admits to three recent episodes of dark red urine in the morning, and significant lethargy in the last few weeks. Which investigation is most likely to elucidate the underlying pathology?

Select the SINGLE most appropriate option from the list below. Select ONE option only.