Case Report
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World J Hepatol. Mar 27, 2013; 5(3): 149-151
Published online Mar 27, 2013. doi: 10.4254/wjh.v5.i3.149
Extrahepatic aneurysm of the portal venous system and portal hypertension
Wilma Debernardi-Venon, Davide Stradella, Greta Ferruzzi, Filippo Marchisio, Chiara Elia, Mario Rizzetto
Wilma Debernardi-Venon, Davide Stradella, Greta Ferruzzi, Chiara Elia, Mario Rizzetto, Gastro-Hepatology Unit, San Giovanni Battista Hospital, University of Turin, 10126 Turin, Italy
Filippo Marchisio, Diagnostic and Interventional Radiology Unit, San Giovanni Battista Hospital, University of Turin, 10126 Turin, Italy
Author contributions: Debernardi-Venon W and Stradella D contributed equally to designing the study, performing the research, analyzing the data and writing the paper; Ferruzzi G performed the research and wrote the paper; Elia C analyzed the data; Marchisio F reconstructed and analyzed the computed tomography images; Debernardi-Venon W and Rizzetto M reviewed the manuscript for intellectual content; and all authors approved the final version of the manuscript.
Correspondence to: Wilma Debernardi-Venon, MD, Gastro-Hepatology Unit, San Giovanni Battista Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy. wilmadebernardi@yahoo.it
Telephone: +39-11-6335558    Fax: +39-11-6335927
Received: November 17, 2012
Revised: January 18, 2013
Accepted: January 29, 2013
Published online: March 27, 2013
Processing time: 132 Days and 10.7 Hours
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.

Keywords: Portal vein aneurysm; Portal hypertension; Gastroesophageal varices; Hepatic venous pressure gradient