Feasibility and safety of non-operative management of portal vein aneurysms: a thirty-five year experience

Ahmed, Ola; Ohman, J. Westley; Vachharajani, Neeta; Yano, Motoyo; Sanford, Dominic E.; Hammill, Chet W.; Fields, Ryan C.; Hawkins, William G.; Strasberg, Steven M.; Doyle, Maria B. Majella; Chapman, William C.; Khan, Adeel

doi:10.1016/j.hpb.2020.05.006

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…[ 15 ] Most patients with a PVA undergo conservative management with close follow-up evaluations. [ 1 , 2 , 16 ] Due to the long-term presence of an abnormal anatomic structure typical of a portosystemic venous shunt, patients are at risk of significant medical complications such as bleeding, pulmonary hypertension, and hepatic encephalopathy. [ 3 ] If the shunt causes symptoms, an active management approach such as ligation or embolization should be adopted.…”

Section: Discussionmentioning

confidence: 99%

Portal vein aneurysm combined with intrahepatic portosystemic venous shunt diagnosed by multimodal imaging techniques: A case report

Liu

Liu²,

Guo

2022

Medicine

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Introduction: Portal vein aneurysms (PVA) and intrahepatic portosystemic venous shunts are rarely diagnosed clinically. Patient Concerns: A 75-year-old female was admitted to our hospital for evaluation of significant weight loss, diabetes, and an irregularly shaped cystic lesion in the left lateral lobe of the liver. Diagnosis: The patient was diagnosed with a portal vein aneurysm combined with an intrahepatic portosystemic venous shunt using multiple imaging techniques. Interventions: The patient had no relevant clinical symptoms of PVA with concurrent intrahepatic portosystemic venous shunt; hence, no interventions were performed. Ultrasonography was suggested to be performed every 3 months. Outcomes: The patient did not visit the hospital after discharge; however, 4 telephonic follow-up evaluations showed that the patient was well. Lessons: Multimodal imaging techniques should be used to evaluate the source of blood flow, presence or absence of shunts, and the course, number, and location of the shunts to prevent misdiagnosis of this disease.

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Section: Discussionmentioning

confidence: 99%

Portal vein aneurysm combined with intrahepatic portosystemic venous shunt diagnosed by multimodal imaging techniques: A case report

Liu

Liu²,

Guo

2022

Medicine

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“…Regarding the location of PVAs, 27.41% were at the level of the splenomesenteric confluence; 19.35% were at the main trunk; 17.74% were at branches; 6.45% were at the PV bifurcation; 6.45% were at the SV; and 4.83% were at the SMV; 14.51% were classified as intrahepatic PVAs. A retrospective study by Ahmed et al [ 2 ] included 18 patients [13 of whom were female (72.2%)], aged between 20 years and 101 years, with an average age of 56 years. Our review also covered three patients (all male) with a PV pseudoaneurysm resulting from trauma.…”

Section: Etiology Multimodal Imaging and Current Managementmentioning

confidence: 99%

“…, should be ruled out. A retrospective study by Ahmed et al [ 2 ] showed that in eight (44.4%) patients with abdominal pain, a PVA was actually the source of the pain in only one patient.…”

Section: Etiology Multimodal Imaging and Current Managementmentioning

confidence: 99%

“…Laurenzi et al [ 1 ] reported PVA complications such as thrombosis (which happened in 20% of cases) and a rupture (which occurred twice). A recent retrospective study by Ahmed et al [ 2 ] reported 18 patients with a PVA; 22.22% of patients had thrombosis, and no ruptures were reported. PVA with a complication of thrombosis is reported in the literature as nearly always being symptomatic, with 91% of patients reporting abdominal pain, 53% reporting fever and 38% presenting with ascites[ 26 ].…”

Section: Etiology Multimodal Imaging and Current Managementmentioning

confidence: 99%

“…Aiming to clarify novelty as regards this visceral vascular abnormality, we performed a literature search of the PubMed database for all articles relating to PVA between January 2015 and July 2022[ 12 - 68 ]. We collected 57 reports, involving 62 patients with a PVA[ 3 - 7 , 12 - 16 , 19 , 21 - 25 , 27 , 29 - 68 ]; we also found one retrospective study with 18 PVA patients[ 2 ], and three cases of PV pseudoaneurysm[ 69 - 71 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Portal vein aneurysm-etiology, multimodal imaging and current management

Kurtcehajic¹,

Zerem²,

Alibegovic³

et al. 2023

World J Clin Cases

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Portal vein aneurysm (PVA) is a rare vascular abnormality, representing 3% of all venous aneurysms in the human body, and is not well understood. It can be congenital or acquired, located mainly at the level of confluence, main trunk, branches and bifurcation. A PVA as an abnormality of the portal venous system was first reported in 1956 by Barzilai and Kleckner. A review from 2015 entitled “Portal vein aneurysm: What to know” considered fewer than 200 cases. In the last seven years, there has been an increase in the number of PVAs diagnosed thanks to routine abdominal imaging. The aim of this review is to provide a comprehensive update of PVA, including aetiology, epidemiology, and clinical assessment, along with an evaluation of advanced multimodal imaging features of aneurysm and management approaches.

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Progress in clinical diagnosis and treatment of cavernous transformation of the portal vein

Li¹,

Sun²,

Sun³

et al. 2021

WCJD

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Feasibility and safety of non-operative management of portal vein aneurysms: a thirty-five year experience

Cited by 5 publications

References 30 publications

Portal vein aneurysm combined with intrahepatic portosystemic venous shunt diagnosed by multimodal imaging techniques: A case report

Portal vein aneurysm combined with intrahepatic portosystemic venous shunt diagnosed by multimodal imaging techniques: A case report

Portal vein aneurysm-etiology, multimodal imaging and current management

Progress in clinical diagnosis and treatment of cavernous transformation of the portal vein

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