Portal vein aneurysm with acute portal vein thrombosis masquerading as a pancreatic mass

Noncirrhotic Portal Hypertension Secondary to Portal Vein Aneurysm

“…Surgical interventions are commonly indicated for complicated cases of PVA: symptomatic patients, progressing aneurysms, rupture and complete thrombosis [14]. PVA with acute PVT has been managed with anticoagulation therapy in non -cirrhotic patients [1,9], although if no clinical improvement is seen, thrombolysis and suction thrombectomy are indicated [15]. Moreno et al considers a surgical approach to treatment for patients with PVA >3cm without thrombosis, [16] in-order to prevent further complications.…”

Asymptomatic portal vein aneurysm: Three case reports

“…Most commonly, symptoms occur in patients with large extrahepatic aneurysmal dilatations while small aneurysms often remain asymptomatic[ 8 , 9 ]. Once thrombosed, PVA causes symptoms such as abdominal pain in 91%, fever in 53% and ascites in 38% of patients[ 10 ]. Authors noted that in symptomatic patients with or without portal hypertension, symptoms do not differ, except for gastrointestinal bleeding in patients suffering from elevated pressure in portal vein[ 1 ].…”

Portal venous aneurysm

“…There are no consensus guidelines for when surgical intervention is indicated, however, should be considered if symptomatic, expanding at a rapid rate, presents a high risk of thrombosis, rupture, compression on adjacent structures or if there is evidence of biliary tract obstruction and haemobilia. 2 Portacaval or mesocaval shunting to reduce portal pressure and prevent progressive dilation of PVA have been described for those with portal hypertension. 3 Thrombectomy has been recommended for patients with PVA associated with thrombosis extending to the superior mesenteric and splenic veins.…”