This article will review the computed tomography (CT) findings in patients with portal vein aneurysms (including presentation of several case examples) and discuss imaging criteria and management options. Given the extreme rarity of portal vein aneurysms, as well as a lack of familiarity with the entity on the part of radiologists, the diagnosis can often be overlooked. Appreciation of the most commonly used diagnostic criteria, as well as the role of CT in the appropriate follow-up of these patients, is critical in ensuring appropriate management. In particular, the significance of these aneurysms must be appreciated in the emergency setting, as portal vein aneurysms can rarely present with symptoms of abdominal pain and other complications (such as thrombosis, portal hypertension, rupture, embolism, and compression of the duodenum and inferior vena cava) making surgical repair necessary.

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