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Kurtcehajic A, Zerem E, Alibegovic E, Kunosic S, Hujdurovic A, Fejzic JA. Portal vein aneurysm-etiology, multimodal imaging and current management. World J Clin Cases 2023; 11:725-737. [PMID: 36818612 PMCID: PMC9928716 DOI: 10.12998/wjcc.v11.i4.725] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/24/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
Portal vein aneurysm (PVA) is a rare vascular abnormality, representing 3% of all venous aneurysms in the human body, and is not well understood. It can be congenital or acquired, located mainly at the level of confluence, main trunk, branches and bifurcation. A PVA as an abnormality of the portal venous system was first reported in 1956 by Barzilai and Kleckner. A review from 2015 entitled “Portal vein aneurysm: What to know” considered fewer than 200 cases. In the last seven years, there has been an increase in the number of PVAs diagnosed thanks to routine abdominal imaging. The aim of this review is to provide a comprehensive update of PVA, including aetiology, epidemiology, and clinical assessment, along with an evaluation of advanced multimodal imaging features of aneurysm and management approaches.
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Affiliation(s)
- Admir Kurtcehajic
- Department of Gastroenterology and Hepatology, Plava Medical Group, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina
| | - Enver Zerem
- Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo 71000, Bosnia and Herzegovina
| | - Ervin Alibegovic
- Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina
| | - Suad Kunosic
- Department of Physics, Faculty of Natural Sciences and Mathematics, University of Tuzla, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina
| | - Ahmed Hujdurovic
- Department of Internal Medicine, Plava Medical Group, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina
| | - Jasmin A Fejzic
- Department of Internal Medicine, General Hospital Tesanj, Tesanj 74260, Bosnia and Herzegovina
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De Vloo C, Matton T, Meersseman W, Maleux G, Houthoofd S, Op de Beeck K, Laleman W, Van Malenstein H, Nevens F, Verbeke L, Van der Merwe S, Verslype C. Thrombosis of a portal vein aneurysm: a case report with literature review. Acta Clin Belg 2019; 74:115-120. [PMID: 30147008 DOI: 10.1080/17843286.2018.1511298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Portal vein aneurysm is an unusual vascular dilatation of the portal vein. The etiology, diagnosis and management are ill-defined. METHODS A case of a portal vein aneurysm complicated with complete thrombosis is presented with a literature review providing an overview of the etiology, clinical presentation and management. RESULTS Portal venous aneurysms represent approximately 3% of all venous aneurysms with a reported prevalence of 0.06%. The reported incidence is on the rise with increasing use of modern imaging techniques in clinical practice. Usually, portal vein aneurysms are incidental findings and patients are asymptomatic. They can be congenital or acquired and portal hypertension represents the most frequent cause of the acquired version. Various complications such as biliary tract compression, portal vein thrombosis, and rupture can occur. Treatment options are conservative management or surgery. Surgical treatment is currently reserved for symptomatic patients with severe abdominal pain, symptoms of pressure effect or with expanding aneurysms, and/or complications such as thrombosis or rupture. CONCLUSION Conservative management seems the best option in the majority of patients. A multidisciplinary approach discussing the best option on a case-by-case base in light of their individual underlying risk and symptoms is advised.
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Affiliation(s)
- Charlotte De Vloo
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Tom Matton
- Radiology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Wouter Meersseman
- General Internal Medicine, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Geert Maleux
- Interventional Radiology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Sabrina Houthoofd
- Vascular surgery, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Katya Op de Beeck
- Radiology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Wim Laleman
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Hannah Van Malenstein
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Frederik Nevens
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Len Verbeke
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Schalk Van der Merwe
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Chris Verslype
- Department of Gastroenterology & Hepatology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
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