Acute Thrombosis of a Giant Portal Venous Aneurysm

Sant’Ana, Patrícia Costa; Jeffrey, R. Brooke; Bastidas, Augusto J.

doi:10.7863/jum.2002.21.6.701

Cited by 21 publications

(9 citation statements)

References 9 publications

(21 reference statements)

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“…15 There is one report of use of aspirin therapy after thrombectomy and aneurysmorrhaphy, which maintained portal vein patency for 3 years postoperatively, and aspirin might reduce risk of recurrent thrombosis. 19 There are also reports of successful conservative management of thrombosed portal vein aneurysm, as in one of our patients. 23,[26][27][28] Aneurysmal thrombosis in the presence of collateral vessels and the absence of mesenteric thrombus extension can be managed with observation.…”

Section: Discussionmentioning

confidence: 71%

“…Similarly, there have been eight reported cases of successful aneurysmorrhaphy in the literature and reported morbidity is low. 9,14,15,[18][19][20][21] For fusiform portal vein aneurysms, if an aneurysmectomy is performed, a conduit to replace the resected portal vein segment is required and an allograft from a cadaveric donor, as in our case, or a synthetic graft can be utilized. The presence of liver disease also influences the surgical procedure chosen for portal vein aneurysm.…”

Section: Discussionmentioning

confidence: 96%

“…Previous reports of five patients who underwent surgery for thrombosis of portal vein aneurysm, and four patients had an excellent outcome postoperatively. 4,[13][14][15]19 The most commonly performed procedures in this group were surgical thrombectomy and aneurysmorrhaphy. There is no report of long-term anticoagulation use for thrombosed portal vein aneurysms.…”

Section: Discussionmentioning

confidence: 99%

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Extrahepatic Portal Vein Aneurysm—Report of Six Patients and Review of the Literature

Cho

Marsh

Fontes

et al. 2008

Journal of Gastrointestinal Surgery

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Extrahepatic portal vein aneurysm is a rare condition. We report six patients with extrahepatic portal vein aneurysm, four of whom were surgically treated. In addition, a review of the literature was performed to examine natural history, management, and outcomes regarding portal vein aneurysm. Patients seen at our institution with extrahepatic portal vein aneurysm greater than 1.9 cm in diameter were reviewed (1998 to 2006). There were five females and one male; median age was 66.5 (30-77). Computed tomography (CT) scan was utilized for diagnosis in all cases. The median diameter of the aneurysm was 4.7 cm (2.7-6.0). Indications for surgery included gallstone pancreatitis, mass effect on the adjacent duodenum, a peripancreatic mass, and liver cirrhosis. Three patients underwent aneurysm resection, and one patient had an orthotropic liver transplant. Two patients were managed with observation. The median follow-up from first presentation and surgery was 50 months (9-181) and 5 months (2-73), respectively. At last follow-up, five patients were alive with radiologically proven portal vein patency. One patient died 2 months after liver transplantation. There was no case of aneurysmal rupture. One patient had intramural thrombus at presentation that resolved with conservative treatment. This report suggests that symptomatic aneurysms can be safely resected with excellent patency.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Extrahepatic Portal Vein Aneurysm—Report of Six Patients and Review of the Literature

Cho

Marsh

Fontes

et al. 2008

Journal of Gastrointestinal Surgery

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“…Nevertheless, authors considered clinically symptomatic patients and complete thrombosis of PVA as indications for surgery [7,9,18]. Brock et al postulated that patients with thrombosis extending to SMV and SV should undergo thrombectomy and restoration of portal vein anatomy [19]; but complication rates of surgical management have not been reported.…”

Section: Discussionmentioning

confidence: 99%

Giant extra-hepatic thrombosed portal vein aneurysm: a case report and review of the literature

et al. 2014

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BackgroundExtrahepatic Portal vein aneurysm (EPVA) is a rare finding that may be associated with different complications, e.g. thrombosis, rupture, portal hypertension and compression of adjacent structures. It is being diagnosed more frequently with the advent of modern cross-sectional imaging. Our review of the English literature disclosed 13 cases of thrombosed EPVA.Case presentationA 50-years-old woman presented with acute abdominal pain but no other symptom. She had no relevant medical history. Palpation of the right upper quadrant showed tenderness. Laboratory tests were unremarkable. A computed tomography showed portal vein aneurysm measuring 88 × 65 mm with thrombosis extending to the superior mesenteric and splenic vein. The patient was treated conservatively with anticoagulation therapy. She was released after two weeks and followed on an outpatient basis. At two months, she reported decreased abdominal pain and her physical examination was normal. A computed tomography was performed showing a decreased thrombosis size and extent, measuring 80 × 55 mm.ConclusionsAlthough rare, surgeons should be made aware of this entity. Complications are various. Conservative therapy should be chosen in first intent in most cases. We reported the case of the second largest thrombosed extra-hepatic PVA described in the literature, treated by anticoagulation therapy with a good clinical and radiological response.

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“…[1][2][3][4][5][6][7] On the other hand, we were able to find only sporadic reports of spontaneous upper extremity venous aneurysms. [8][9][10][11][12][13][14] Most upper extremity spontaneous aneurysms are in the basilic veins.…”

Section: Case Reportmentioning

confidence: 95%

Primary Axillary Venous Aneurysm: Report of a Case

Chu

Lin

et al. 2005

Surg Today

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We report a case of nontraumatic, spontaneous venous aneurysm of the left axillary vein. This case may represent only the second such case ever reported in the English-language medical literature. Venous aneurysms are often associated with trauma, arteriovenous fistula, or other venous abnormal hemodynamic conditions, but true primary venous aneurysms are very rare. Surgical excision was uncomplicated and performed easily.

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Acute Thrombosis of a Giant Portal Venous Aneurysm

Cited by 21 publications

References 9 publications

Extrahepatic Portal Vein Aneurysm—Report of Six Patients and Review of the Literature

Extrahepatic Portal Vein Aneurysm—Report of Six Patients and Review of the Literature

Giant extra-hepatic thrombosed portal vein aneurysm: a case report and review of the literature

Primary Axillary Venous Aneurysm: Report of a Case

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