Asymptomatic saccular portal vein aneurysm: a case report and review of the literature

Abstract

Portal vein aneurysms are rare abnormal dilations of the portal vein and represent less than 3% of all visceral aneurysms. They may be congenital or acquired, symptomatic or asymptomatic, complicated or uncomplicated. Portal vein aneurysms may be fusiform or saccular and this last one has a low prevalence. Due to the small number of cases reported in the medical literature and the lack of specific guidelines, the management and treatment of this condition is still undefined. In this review, we report a case of saccular portal vein aneurysm in a 73-year old man with liver cirrhosis and discuss all cases of portal vein aneurysms reported in literature.

Operative treatment of portal vein aneurysm

“…Asymptomatic PV aneurysms are observed with serial imaging, symptomatic aneurysms associated with cirrhosis are treated with operative shunting/bypass or liver transplant, and aneurysmorrhaphy/aneurysmectomy is performed in patients with healthy livers [ 2 ]. Selection of aneurysmorrpahy or aneurysmectomy is dependent on whether the aneurysm is fusiform or saccular, respectively [ 4 ]. Perioperative anticoagulation/antiplatelet therapy after PV reconstruction remains a topic of debate with little evidence to guide management.…”