Most cases demonstrating extrahepatic venous collateral formation are the result of extensions of the portal venous system. This provides an outlet for venous drainage from the congested liver, usually in cases of portal hypertension. The case presented here, in a patient with systemic lupus erythematosus, antiphospholipid syndrome, and Budd-Chiari syndrome, is a demonstration of extrahepatic venous collateral formation originating from the hepatic veins in the liver. This rare case has features that are easily demonstrated using color and pulsed-wave Doppler sonography.