Portal vein aneurysm

Case contributed by Angel Romero Domínguez
Diagnosis certain

Presentation

Asymptomatic patient, suffering from cirrhosis, surveillance ultrasound.

Patient Data

Age: 60 years
Gender: Female
ultrasound

Liver decrease in size, overall coarse and heterogeneous echotexture, without focal lesions. Enlarged portal vein (16 mm) with intrahepatic saccular dilatation of 2.5 x 2.2 cm. Doppler ultrasound demonstrates turbulent flow, yin-yang sign/ Pepsi sign is noted.

The spleen is enlarged, with a volume of 528 ml.

Case Discussion

The findings correspond to an intrahepatic aneurysm of the portal vein 1-8 in a patient with cirrhosis, portal hypertension, and splenomegaly.

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