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Splenorenal shunt venous aneurysm

Case contributed by Yahya Baba
Diagnosis certain

Presentation

CT follow-up after radiofrequency ablation of an HCC.

Patient Data

Age: 75 years
Gender: Female

Portosystemic collateral pathways and splenomegaly.

Dilated vascular structure demonstrating venous enhancement pattern, communicating with a collateral vein between the splenic and the left renal veins (splenorenal shunt), in keeping with a venous aneurysm.

Lipiodol marked hepatic lesion in segment VIII with radiofrequency ablation sequela.

Hepatic cirrhosis with diffuse fatty liver disease.

Regular and circumferential thickening of the gastric wall, in keeping with portal hypertensive gastropathy.

No lymphadenopathy. No ascites. No portal vein thrombosis.

Case Discussion

Splenorenal shunt venous aneurysms are rare, and should not be underdiagnosed since these lesions grow as the portal venous pressure rises, with an increased risk of rupture. They could be treated with balloon-occluded retrograde transvenous obliteration1.

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