Chaubard S, Lacroix P, Kennel C, Jaccard A
Service d'hématologie clinique et de thérapie cellulaire du CHU de Limoges, 2, avenue Martin Luther-King, 87000 Limoges, France.
Service de chirurgie vasculaire et thoracique-médecine vasculaire du CHU de Limoges, 2, avenue Martin Luther-King, 87000 Limoges, France.
Rev Med Interne. 2018 Dec;39(12):946-949. doi: 10.1016/j.revmed.2018.07.007. Epub 2018 Aug 23.
Portal vein aneurysms are rare, representing 3% of venous aneurysms, with about 200 cases described in the literature, probably underestimated.
A 66-year-old man, suspect of splenomegaly, underwent an abdominal ultrasound and a thoraco-abdomino-pelvic CT scan showing a 40mm portal vein aneurysm. Final diagnosis was T-cell hemopathy. Five and six months later, abdominal imaging was stable, suggesting congenital origin due to lack of obliteration of the vitelline vein.
Portal vein aneurysms are often asymptomatic and an incidental finding. Monitoring is recommended because of their potential complications (thrombosis, rupture of aneurysm, portal hypertension, adjacent organs compression), annually if asymptomatic or more frequently with sometimes a surgical management in case of clinical manifestations.
门静脉瘤罕见,占静脉瘤的3%,文献报道约200例,可能存在低估。
一名66岁男性,怀疑有脾肿大,接受了腹部超声和胸腹部盆腔CT扫描,显示有一个40mm的门静脉瘤。最终诊断为T细胞血液病。五六个月后,腹部影像学检查结果稳定,提示因卵黄静脉未闭塞而起源于先天性。
门静脉瘤通常无症状,多为偶然发现。因其可能出现并发症(血栓形成、动脉瘤破裂、门静脉高压、压迫邻近器官),故建议进行监测,无症状时每年监测一次,若有临床表现则监测更频繁,有时需手术治疗。