title: Giant Intrahepatic Portal Vein Aneurysm: Leave it or Treat it?
abstract: Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction. Differential diagnoses of portal vein aneurysms are solid, cystic, and hypervascular abdominal masses, and it is important that the radiologists be aware of their multi-modality appearance; hence, the aim of this article was to provide an overview of the available literature to better simplify various aspects of this rare entity and diagnostic appearance on different modality with available treatment options. In our case, a 55-year-old male patient came to the gastroenterology OPD for further management of pancreatitis with portal hypertension and biliary obstruction with plastic stents in CBD and PD for the same. In this article, we have reported a case of largest intrahepatic portal vein aneurysm and its management by endovascular technique. As per our knowledge, this is the largest intrahepatic portal vein aneurysm and first case where the endovascular technique was used for the treatment of the same.
authors.affiliation: McGill University, Montreal, Canada.
authors.forename: Amit
authors.initials: A
authors.lastname: Shrivastava
authors.affiliation: Chief, Department of Intervention Radiology, Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Jagdeesh S
authors.initials: JS
authors.lastname: Rampal
authors.affiliation: Director, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: D
authors.initials: D
authors.lastname: Nageshwar Reddy
keywords: CBD, common bile duct; DSA, Digital Subtraction Angiography; MDCT, multi detector computed tomography; MRI, magnetic resonance imaging; PD, pancreatic duct; PVA, portal vein aneurysm; USG, ultrasonography; aneurysm; embolization; portal vein