Kim Hye Jin, Ha Tae-Yong, Ko Gi-Young, Noh Minsu, Kwon Tae-Won, Cho Yong-Pil, Lee Sung-Gyu
Ewha Womans University School of Medicine, Seoul, Republic of Korea.
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
Ann Vasc Surg. 2017 Aug;43:311.e9-311.e13. doi: 10.1016/j.avsg.2017.01.020. Epub 2017 May 3.
Portal vein (PV) aneurysm is a rare disease entity, and the optimal strategy for its management remains unclear.
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.
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.
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.
门静脉（PV）动脉瘤是一种罕见的疾病实体，其最佳治疗策略仍不明确。
我们描述了一名34岁女性的病例，她被偶然诊断为无症状的肝外PV动脉瘤。尽管采取了定期随访和监测成像的观察性治疗，但PV动脉瘤进展为有症状类型，并伴有急性血栓形成的并发症。因此，进行了动脉瘤切除并置入旁路手术。
她术后恢复迅速且顺利，肝功能测试结果在正常范围内，彩色多普勒超声和增强计算机断层扫描显示门静脉血流正常。
在已报道的PV动脉瘤病例中，血栓形成的发生率可能明显较高，因此可能需要对低风险患者进行早期手术干预，以预防具有临床严重后果的门静脉高压的发生。
