Portal venous varix
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Aneurysms of theportal vein is extremely rare and represent only 3% of all aneurysms of the venous system 1.
Clinical presentation
Most patients are asymptomatic asymptomatic, but may present with nonspecific nonspecific abdominal pain as a major symptom2-4.
Pathology
Both congenital and acquired causes have been proposed. Acquired causes causes may include2-3:
-
portal hypertension: could be contributory but is not essential to the development of portal venous system aneurysms and
majoritymajority of patients do not have portal hypertension or chronic liver disease. - necrotizing pancreatitis
- abdominal trauma or surgery
Location
The most common locations for aneurysms of the portal venous system are are 2-3:
- splenomesenteric venous confluence
- main portal vein
- intrahepatic portal vein branches at bifurcation sites
And the rarest locations are splenic splenic, mesenteric, and umbilical veins.
Radiographic features
Ultrasonography
Color Doppler ultrasound is the most helpful diagnostic tool. Further work-up may not be necessary 4. Appearing on ultrasound as as anechoic masses showing direct luminal continuity with the portal venous system and displayed spectral findings characteristic of portal venous system on colour Doppler ultrasound5-6.
CT
Dynamic helical CT demonstrated simultaneous enhancement with the portal system 5-6.
MRI
On MR images aneurysms aneurysms were hypointense owing to flow void on T1-weighted 5.
Complications
Complications include 2-4:
- thrombosis and distal embolism
- portal hypertension
- rupture
- compression of the duodenum
- compression of the common bile duct causing jaundice, cholestasis, andcholelithiasis
-<p><strong>Aneurysms of the <a href="/articles/portal-vein">portal vein</a></strong> is extremely rare and represent only 3% of all <a href="/articles/aneurysms-of-the-venous-system">aneurysms of the venous system</a> <sup>1</sup>.</p><h4>Clinical presentation</h4><p>Most patients are asymptomatic, but may present with nonspecific abdominal pain as a major symptom <sup>2-4</sup>.</p><h4>Pathology</h4><p>Both congenital and acquired causes have been proposed. Acquired causes may include <sup>2-3</sup>:</p><ul>- +<p><strong>Aneurysms of the <a href="/articles/portal-vein">portal vein</a></strong> is extremely rare and represent only 3% of all <a href="/articles/aneurysms-of-the-venous-system">aneurysms of the venous system</a> <sup>1</sup>.</p><h4>Clinical presentation</h4><p>Most patients are asymptomatic, but may present with nonspecific abdominal pain as a major symptom <sup>2-4</sup>.</p><h4>Pathology</h4><p>Both congenital and acquired causes have been proposed. Acquired causes may include <sup>2-3</sup>:</p><ul>
-<a href="/articles/portal-hypertension">portal hypertension</a>: could be contributory but is not essential to the development of portal venous system aneurysms and majority of patients do not have portal hypertension or chronic liver disease.</li>- +<a href="/articles/portal-hypertension">portal hypertension</a>: could be contributory but is not essential to the development of portal venous system aneurysms and majority of patients do not have portal hypertension or chronic liver disease.</li>
-</ul><h5>Location</h5><p>The most common locations for aneurysms of the portal venous system are <sup>2-3</sup>:</p><ul>- +</ul><h5>Location</h5><p>The most common locations for aneurysms of the portal venous system are <sup>2-3</sup>:</p><ul>
-</ul><p>And the rarest locations are splenic, mesenteric, and umbilical veins.</p><h4>Radiographic features</h4><h5>Ultrasonography</h5><p>Color Doppler ultrasound is the most helpful diagnostic tool. Further work-up may not be necessary <sup>4</sup>. Appearing on ultrasound as anechoic masses showing direct luminal continuity with the portal venous system and displayed spectral findings characteristic of portal venous system on colour Doppler ultrasound <sup>5-6</sup>.</p><h5>CT</h5><p>Dynamic helical CT demonstrated simultaneous enhancement with the portal system <sup>5-6</sup>.</p><h5>MRI</h5><p>On MR images aneurysms were hypointense owing to flow void on T1-weighted <sup>5</sup>.</p><h4>Complications</h4><p>Complications include<sup> 2-4</sup>:</p><ul>- +</ul><p>And the rarest locations are splenic, mesenteric, and umbilical veins.</p><h4>Radiographic features</h4><h5>Ultrasonography</h5><p>Color Doppler ultrasound is the most helpful diagnostic tool. Further work-up may not be necessary <sup>4</sup>. Appearing on ultrasound as anechoic masses showing direct luminal continuity with the portal venous system and displayed spectral findings characteristic of portal venous system on colour Doppler ultrasound <sup>5-6</sup>.</p><h5>CT</h5><p>Dynamic helical CT demonstrated simultaneous enhancement with the portal system <sup>5-6</sup>.</p><h5>MRI</h5><p>On MR images aneurysms were hypointense owing to flow void on T1-weighted <sup>5</sup>.</p><h4>Complications</h4><p>Complications include<sup> 2-4</sup>:</p><ul>
-<li>compression of the <a href="/articles/common-bile-duct">common bile duct</a> causing <a href="/articles/jaundice">jaundice</a>, cholestasis, and <a href="/articles/cholelithiasis">cholelithiasis</a>- +<li>compression of the <a href="/articles/common-bile-duct">common bile duct</a> causing <a href="/articles/jaundice">jaundice</a>, cholestasis, and <a href="/articles/cholelithiasis">cholelithiasis</a>
Images Changes:
Image 2 CT (C+ portal venous phase) ( create )
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