Thrombosis of a large portal vein aneurysm: treatment by thrombectomy, aneurysmorrhaphy, and portocaval shunt.
An otherwise healthy 32-year-old woman had unspecific upper abdominal complaints. Diagnostic work-up, including a helical computed tomography (CT) scan and indirect splenoportography, revealed a giant extrahepatic portal vein aneurysm (PVA) extending to the central part of the splenic vein. On laparotomy, a thrombectomy and creation of a portocaval side-to-side shunt were performed. Thirteen days later, she was readmitted for re-thrombosis of the aneurysm. She underwent another laparotomy with thrombectomy and tapering of the portal venous wall (aneurysmorrhaphy) by vascular staplers. On follow-up 25 months after the operation, full relief of symptoms was noted. She was on warfarin therapy. Her portal venous system was patent.
Wolff
Martin
M
Department of Surgery, University of Bonn, Germany. martin.wolff@ukb.uni-bonn.de
Schaefer
Nico
N
Schmidt
Joachim
J
Hirner
Andreas
A
D000328:Adult; D000783:Aneurysm / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D008641:Mesenteric Vascular Occlusion / Q000601:surgery; D008642:Mesenteric Veins / Q000601:surgery; D011169:Portal Vein / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical; D011172:Portography; D012008:Recurrence; D012086:Reoperation; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000601:surgery; D017792:Surgical Stapling; D017131:Thrombectomy; D036542:Tomography, Spiral Computed; D020246:Venous Thrombosis / Q000601:surgery*