Massive Portal Vein Aneurysm

Portal vein aneurysm is rare, with incidence ranging from 0.06% to 0.43%. Serious complications include rupture, thrombosis, or compressive effects on nearby structures. Most cases in the literature have followed conservative treatment. Here we report case of a patient large asymptomatic portal that was surgically repaired. A 74-year-old man referred vascular surgery Computed tomography (CT) imaging demonstrating saccular at posterior aspect measuring 5.1 cm × 2.7 3.9 (Figure). He denied abdominal pain, history liver abnormalities, alcohol overuse. His physical examination benign. had excellent functional status and suitable anatomy recommended for operative repair. underwent open bovine pericardial patch reconstruction vein. On postoperative day 4, he significant sanguineous output his drain. CT scan concerning thrombosis returned operating room interposition graft right femoral conduit thromboembolectomy. Completion venous angiography demonstrated patency branches no residual thrombus. discharged home 16 after prolonged hospital course. has been clinic 24 months; duplex ultrasound continues show graft, remains symptom free. There are limited reports literature, less than 300 published. The majority follow management serial imaging, trend likely stems paucity evidence-based guidelines long-term, rigorous case-control data. Operative intervention suggested aneurysms symptomatic, ruptured, rapidly increasing size. Asymptomatic 3 not intervention, but treatment greater clear. Sequelae may be severe, some authors cm. series elective favorable long-term outcomes. Clinical needed help prevent morbidity mortality.