Portal venous aneurysm

Case contributed by Dr Alex Jarema

Presentation

Fall at home with T12 fracture. Found to have PR bleeding during hospital admission. CT abdomen for further assessment.

Patient Data

Age: 90 year old
Gender: Male
CT

48 x 25 mm intra-hepatic portal venous aneurysm extends from the bifurcation of the left and right portal veins. The main portal vein measures 12 mm in diameter. No evidence of dilated periumbilical veins or varices.

11 mm liver cyst within segment II. The liver is otherwise normal. 20 mm right lower pole simple renal cyst. The remaining intra-abdominal hollow and solid viscera appear unremarkable.

Bilateral small to moderate pleural effusions.

Fracture of the superior end-plate of T12.

Ultrasound

Aneurysm arising from the proximal left portal vein measuring 48 x 21 x 39 mm with a neck of 13 mm. No thrombus is demonstrated within the aneurysm.

Case Discussion

Incidental finding of a large 4.8 cm intra-hepatic portal vein aneurysm in a 90 year old male being investigated for PR bleeding.

The patient was reviewed by the vascular surgery team, however given the patient's advanced age and the asymptomatic nature of the aneurysm, conservative management was recommended.

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Case information

rID: 43913
Case created: 29th Mar 2016
Last edited: 8th May 2016
Inclusion in quiz mode: Included

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