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Case Reports
. 2021 Aug 30;16(11):3369-3373.
doi: 10.1016/j.radcr.2021.08.010. eCollection 2021 Nov.

A rare case of congenital aneurysm of the portal system at level of spleno-porto-mesenteric confluence complicated by massive thrombosis

Valerio D'Agostino  1 , Stefano Genovese  1 , Alessandro Monaci  1 , Arnaldo Stanzione  1 , Mario Magliulo  2 , Stefania Daniele  3 , Maria Giovanna di Palo  3 , Simone Maurea  1 , Pierpaolo Mainenti  2
Affiliations
Case Reports

A rare case of congenital aneurysm of the portal system at level of spleno-porto-mesenteric confluence complicated by massive thrombosis

Valerio D'Agostino et al. Radiol Case Rep. .

Abstract

Portal venous aneurysm is a rare and potential dangerous vascular pathology, which can result in thrombosis or rupture. It may be congenital or acquired. Acquired form can be related mainly to portal hypertension, chronic hepatic disease, and trauma. We present a peculiar case of a congenital aneurysm involving the hepatic portal system in nearly all its extra-hepatic components: the main portal trunk, the spleno-porto-mesenteric confluence and the distal segment of splenic, superior, and inferior mesenteric veins, in a 20-year-old male patient. The aneurysm was complicated by massive thrombosis in absence of further predisposing factors.

Keywords: Chronic pancreatitis; Computed tomography; Congenital aneurysm; Emergency radiology; Gastrointestinal radiology; Magnetic resonance imaging.

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Figures

Fig 1
Fig. 1
(A-C) Contrast-enhanced portal phase CT scan: The coronal MIP images depicts a large venous aneurysm with a superimposed massive thrombosis involving the portal vein (red arrow), the superior mesenteric vein (blue arrow), the splenic vein (white arrow), and the inferior mesenteric vein (green arrow). Enlarged spleen is also observed (Color version of the figure is available online.)
Fig 2
Fig. 2
(A and B) Contrast-enhanced portal phase CT scan: The coronal oblique MIP (a) and the axial (b) images depicts: (A) vicariant activation of the capsular venous branches (blue arrow) with an enlarged right hepatic vein (yellow arrow); (B) large intra and extra-glandular fluid collections at pancreatic tail level (orange arrows) (Color version of the figure is available online.)
Fig 3
Fig. 3
Contrast enhanced portal phase MRI scan. The coronal MIP image shows a complete recanalization of the portal venous system with persistent aneurysmal dilatation of portal vein (red arrow) and of the distal segment of superior mesenteric vein (blue arrow), inferior mesenteric vein (green arrow), and splenic vein (white arrow) (Color version of the figure is available online.)
See this image and copyright information in PMC

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