A Case of Extrahepatic Portal Vein Aneurysm Complicated by Acute Thrombosis

Background: Portal vein (PV) aneurysm is a rare disease entity, and the optimal strategy for its management remains unclear. Methods: We describe the case of a 34-year-old woman who was incidentally diagnosed with an asymptomatic extrahepatic PV aneurysm. Although expectant management with regular follow-up and surveillance imaging was adopted, the PV aneurysm progressed into a symptomatic type, accompanied by complications of acute thrombosis. Hence, an aneurysm excision with interposition bypass was performed. Results: Her postoperative recovery was rapid and uneventful, with liver function test results within normal ranges and normal portal flow on color Doppler ultrasonography and contrast-enhanced computed tomography. Conclusions: The incidence of thromboses among the reported PV aneurysm cases may be markedly high, and early surgical intervention for low-risk patients may therefore be required to prevent the development of portal hypertension with clinically severe consequences.