Superior mesenteric venous aneurysm.
The case of a 50-year-old woman with an extremely rare venous malformation of the portal venous system is reported. The patient presented with a true aneurysm of the superior mesenteric vein, which has thus far been reported in no more than eight cases worldwide. This malformation may be congenital or acquired. Secondary aneurysms are thought to be due to liver disease, portal hypertension, trauma, or inflammation. Aneurysms of the portomesenteric venous system may be asymptomatic or give rise to severe, often dramatic conditions such as crampy abdominal pain, jaundice, and upper gastrointestinal hemorrhage secondary to portal hypertension. The diagnosis is usually made by ultrasound (B-mode or color flow Doppler), CT scan, and MRI. Invasive procedures such as venous phase mesenteric arteriography or splenoportography may be helpful in confirming it. In our opinion aneurysms of the portal venous system, even if they are congenital and (still) asymptomatic, require early surgical control because the prognosis for patients with these aneurysms is unpredictable and potential complications (e.g., portal hypertension, fistula, contained perforation, or rupture) may be fatal. In the case presented the mesenteric venous aneurysm was resected and the confluent veins were reconstructed.
Lerch
R
R
Department of Vascular and Thoracic Surgery, Zentralklinikum Augsburg, Germany.
Wölfle
K D
KD
Loeprecht
H
H
D000783:Aneurysm / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D008642:Mesenteric Veins / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color