title: Giant extra-hepatic thrombosed portal vein aneurysm: a case report and review of the literature.
abstract: BACKGROUND
  Extrahepatic Portal vein aneurysm (EPVA) is a rare finding that may be associated with different complications, e.g. thrombosis, rupture, portal hypertension and compression of adjacent structures. It is being diagnosed more frequently with the advent of modern cross-sectional imaging. Our review of the English literature disclosed 13 cases of thrombosed EPVA.
  
  
  METHODS
  A 50-years-old woman presented with acute abdominal pain but no other symptom. She had no relevant medical history. Palpation of the right upper quadrant showed tenderness. Laboratory tests were unremarkable. A computed tomography showed portal vein aneurysm measuring 88 × 65 mm with thrombosis extending to the superior mesenteric and splenic vein. The patient was treated conservatively with anticoagulation therapy. She was released after two weeks and followed on an outpatient basis. At two months, she reported decreased abdominal pain and her physical examination was normal. A computed tomography was performed showing a decreased thrombosis size and extent, measuring 80 × 55 mm.
  
  
  CONCLUSIONS
  Although rare, surgeons should be made aware of this entity. Complications are various. Conservative therapy should be chosen in first intent in most cases. We reported the case of the second largest thrombosed extra-hepatic PVA described in the literature, treated by anticoagulation therapy with a good clinical and radiological response.
authors.affiliation: Department of Visceral Surgery, CHUV University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
authors.forename: Ismaïl
authors.initials: I
authors.lastname: Labgaa
authors.affiliation: Department of Radiology and Interventional Radiology, CHUV University Hospital, Lausanne, Switzerland.
authors.forename: Yann
authors.initials: Y
authors.lastname: Lachenal
authors.affiliation: Department of Visceral Surgery, CHUV University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Allemann
authors.affiliation: Department of Visceral Surgery, CHUV University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
authors.affiliation: Department of Visceral Surgery, CHUV University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Schäfer
keywords: Aneurysm; Portal vein; Thrombosis