A case of extrahepatic portal vein aneurysm with the remarkably bent bile duct by its displacement

A 50-year-old man with type B liver cirrohosis was admitted with jaundice and ascites. He had undergone an operation for esophageal variceal rupture at another hospital. Abdominal CT scan and ultrasonography showed cystic dilatation of the extrahepatic portal vein, and Doppler ultrasonography showed it to be a portal vein aneurysm. After admission, jaundice progressed, and not only liver failure but also biliary tract obstruction was suspected as its etiology. Therefore, endoscopic retrograde cholangiography was performed, and it showed a remarkably bent extrahepatic bile duct thought to be caused by extrinsic compression. By combining the finding of endoscopic ultrasonography, we considered that the portal vein aneurysm had displaced the bile duct. We suspected that it also caused cholestasis and cholangitis.