Published online Apr 27, 2021. doi: 10.4254/wjh.v13.i4.515
Peer-review started: December 14, 2020
First decision: February 13, 2021
Revised: February 19, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: April 27, 2021
Processing time: 119 Days and 21.7 Hours
Portal vein aneurysm (PVA) is an uncommon vascular dilatation, showing no clear trend in sex or age predominance. Due to the low number of published cases and the lack of management guidelines, treatment of this condition remains a clinical challenge.
We present three cases of asymptomatic PVA; the first and second involve an extrahepatic manifestation, of 48 mm and 42.3 mm diameter respectively, and the third involves an intrahepatic PVA of 27 mm. All were diagnosed incidentally during routine check-up, upon ultrasonography scan. Since all patients were asymptomatic, a conservative treatment strategy was chosen. Follow-up imaging demonstrated no progression in the aneurysm dimension for any case.
As PVA remains asymptomatic in many cases, recognition of its imaging features is key to favourable outcomes.
Core Tip: Portal vein aneurysm (PVA) can be a congenital or acquired vascular malformation but in most cases is asymptomatic; as such, it remains underdiagnosed. We report on the features of PVA detected by ultrasonography, computed tomography and magnetic resonance imaging in three asymptomatic patients. Only one of our patients had a known predisposing factor (i.e., liver cirrhosis). Throughout the surveillance period, our patients remained asymptomatic, with no dimensional changes in their PVAs. In reporting this case study, we highlight the need for PVA recognition and instituting a personalized management approach that takes into consideration factors predisposing to complications of this condition.