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Case Reports
. 2021 Apr 27;13(4):515-521.
doi: 10.4254/wjh.v13.i4.515.

Asymptomatic portal vein aneurysm: Three case reports

Kateryna Priadko  1 , Marco Romano  2 , Luigi Maria Vitale  2 , Marco Niosi  2 , Ilario De Sio  2
Affiliations
Case Reports

Asymptomatic portal vein aneurysm: Three case reports

Kateryna Priadko et al. World J Hepatol. .

Abstract

Background: Portal vein aneurysm (PVA) is an uncommon vascular dilatation, showing no clear trend in sex or age predominance. Due to the low number of published cases and the lack of management guidelines, treatment of this condition remains a clinical challenge.

Case summary: We present three cases of asymptomatic PVA; the first and second involve an extrahepatic manifestation, of 48 mm and 42.3 mm diameter respectively, and the third involves an intrahepatic PVA of 27 mm. All were diagnosed incidentally during routine check-up, upon ultrasonography scan. Since all patients were asymptomatic, a conservative treatment strategy was chosen. Follow-up imaging demonstrated no progression in the aneurysm dimension for any case.

Conclusion: As PVA remains asymptomatic in many cases, recognition of its imaging features is key to favourable outcomes.

Keywords: Asymptomatic; Case report; Colour Doppler; Extrahepatic portal vein aneurysm; Intrahepatic portal vein aneurysm; Ultrasonography imaging.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Abdominal ultrasonographic imaging of Case 1. A: Anechoic lesion corresponding to a notably dilated extrahepatic portal vein (arrow); B: Colour Doppler showed the “Korean flag” pathological sign in the dilated portal vein; C: Doppler recording showed flat venous flow.
Figure 2
Figure 2
Abdominal ultrasonographic imaging of Case 2. A: Extrahepatic anechoic saccular lesion, indicating an aneurysmal dilation of the extrahepatic portal vein (arrow); B: The anechoic lesion was 42.3 mm at its maximal diameter; C: Colour Doppler showed hepatopetal venous flow in the extrahepatic aneurysmal dilated vessel; D: Doppler recording showed pulsating flow of venous type.
Figure 3
Figure 3
Abdominal computed tomographic scanning of Case 2. The axial image showed saccular extrahepatic aneurysmal dilatation of the portal vein (arrow).
Figure 4
Figure 4
Contrast-enhanced magnetic resonance imaging of the abdomen of Case 2. The axial image showed saccular extrahepatic aneurysmal dilatation of the portal vein (arrow).
Figure 5
Figure 5
Abdominal ultrasonographic imaging of Case 3. A: Anechoic lesion of the right branch of the portal vein (arrow); B: The intrahepatic anechoic lesion was 27 mm at its maximal diameter; C: Colour Doppler showed the “Korean flag” pathological sign.
See this image and copyright information in PMC

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