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.