Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2858-2861
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2858
Portal vein aneurysm associated with Budd-Chiari syndrome treated with transjugular intrahepatic portosystemic shunt: A case report
Jiaywei Tsauo, Xiao Li
Jiaywei Tsauo, Xiao Li, Institute of Interventional Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jiaywei Tsauo, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Li X performed the procedure; Tsauo J and Li X wrote the paper.
Supported by National Natural Science Fund of China, No. 81371656 and No. 81171444 to Xiao Li.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao Li, MD, PhD, Professor, Director, Institute of Interventional Radiology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. simonlixiao@hotmail.com
Telephone: +86-28-85582944 Fax: +86-28-85582944
Received: September 13, 2014
Peer-review started: September 13, 2014
First decision: September 27, 2014
Revised: September 30, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: March 7, 2015
Processing time: 177 Days and 14.5 Hours
Abstract

A 65-year-old woman with Budd-Chiari syndrome (BCS) presented with right upper quadrant pain. A computed tomography (CT) scan showed a saccular aneurysm located at the extrahepatic portal vein main branch measuring 3.2 cm in height and 2.5 cm × 2.4 cm in diameter. The aneurysm was thought to be associated with BCS as there was no preceding history of trauma and it had not been present on Doppler ultrasound examination performed 3 years previously. Because of increasing pain and concern for complications due to aneurysm size, the decision was made to relieve the hepatic venous outflow obstruction. Transjugular intrahepatic portosystemic shunt (TIPS) was created without complications. She had complete resolution of her abdominal pain within 2 d and remained asymptomatic after 1 year of follow-up. CT scans obtained after TIPS showed that the aneurysm had decreased in size to 2.4 cm in height and 2.0 cm × 1.9 cm in diameter at 3 mo, and had further decreased to 1.9 cm in height and 1.6 cm × 1.5 cm in diameter at 1 year.

Keywords: Portal vein aneurysm; Portal hypertension; Portosystemic shunt; Budd-Chiari syndrome; Transjugular intrahepatic portosystemic shunt

Core tip: Portal vein aneurysm (PVA) is a rare clinical entity defined as abnormal dilation of the portal vein ≥ 2 cm in diameter. Observation is advocated for asymptomatic aneurysms, whereas symptomatic and enlarging aneurysms are recommended for surgery. To date, the utility of transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of PVA has not been described. Herein, we report a case of extrahepatic PVA in a patient with Budd-Chiari syndrome treated with a TIPS.