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Extrahepatic Portal Vein Aneurysm—Report of Six Patients and Review of the Literature

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Extrahepatic portal vein aneurysm is a rare condition. We report six patients with extrahepatic portal vein aneurysm, four of whom were surgically treated. In addition, a review of the literature was performed to examine natural history, management, and outcomes regarding portal vein aneurysm. Patients seen at our institution with extrahepatic portal vein aneurysm greater than 1.9 cm in diameter were reviewed (1998 to 2006). There were five females and one male; median age was 66.5 (30–77). Computed tomography (CT) scan was utilized for diagnosis in all cases. The median diameter of the aneurysm was 4.7 cm (2.7–6.0). Indications for surgery included gallstone pancreatitis, mass effect on the adjacent duodenum, a peripancreatic mass, and liver cirrhosis. Three patients underwent aneurysm resection, and one patient had an orthotropic liver transplant. Two patients were managed with observation. The median follow-up from first presentation and surgery was 50 months (9–181) and 5 months (2–73), respectively. At last follow-up, five patients were alive with radiologically proven portal vein patency. One patient died 2 months after liver transplantation. There was no case of aneurysmal rupture. One patient had intramural thrombus at presentation that resolved with conservative treatment. This report suggests that symptomatic aneurysms can be safely resected with excellent patency.

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Acknowledgment

Supported by the NIH Roadmap Multidisciplinary Clinical Research Career Development Award Grant (K12 HD049109) from the National Institute of Health.

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Authors and Affiliations

  1. Department of Surgery, UPMC Liver Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA

    Sung W. Cho, J. Wallis Marsh, Paulo A. Fontes, Michael F. Daily, Michael E. De Vera, David A. Geller & T. Clark Gamblin

  2. Department of Pathology, UPMC Liver Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA

    Michael Nalesnik

  3. Department of Radiology, UPMC Liver Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA

    Mitch Tublin

  4. UPMC Liver Cancer Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA

    T. Clark Gamblin

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  1. Sung W. Cho
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Correspondence to T. Clark Gamblin.

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Cho, S.W., Marsh, J.W., Fontes, P.A. et al. Extrahepatic Portal Vein Aneurysm—Report of Six Patients and Review of the Literature. J Gastrointest Surg 12, 145–152 (2008). https://doi.org/10.1007/s11605-007-0313-x

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