Extrahepatic aneurysm of the portal venous system and portal hypertension |
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Authors: | Wilma Debernardi-Venon Davide Stradella Greta Ferruzzi Filippo Marchisio Chiara Elia Mario Rizzetto |
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Institution: | Wilma Debernardi-Venon, Davide Stradella, Greta Ferruzzi, Chiara Elia, Mario Rizzetto, Gastro-Hepatology Unit, San Giovanni Battista Hospital, University of Turin, 10126 Turin, ItalyFilippo Marchisio, Diagnostic and Interventional Radiology Unit, San Giovanni Battista Hospital, University of Turin, 10126 Turin, Italy |
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Abstract: | Portal venous aneurysm (PVA) is a rare condition characterized by dilatation of the portal venous system. PVA manifestation of symptoms is varied and depends on the aneurysm size, location and related-complications, such as thrombosis. While the majority of reported cases of PVA are attributed to portal hypertension, very little is known about the condition’s pathophysiology and clinical management remains a challenge. Here, we describe a 67-year-old woman who presented with complaint of dyspepsia and without a significant medical history, for whom PVA was incidentally diagnosed. The initial upper abdominal ultrasound revealed marked dilatation of the main portal vein, and subsequent contrast-enhanced computed tomography with angiography revealed a large aneurysm arising from the extrahepatic troncus portion of the portal vein, as well as gastroesophageal varices. A conservative approach using beta-blocker therapy was chosen. The patient was followed-up for 60 mo, during which time the asymptomatic status was unaltered and the PVA remained stable. |
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Keywords: | Portal vein aneurysm Portal hypertension Gastroesophageal varices Hepatic venous pressure gradient |
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