A 62-year-old Caucasian woman was found to have an aneurysm of the splenomesenteric portal venous confluence via computed tomography (CT) scan after presenting with left upper abdominal tenderness. Venous aneurysms typically occur in the popliteal, jugular, and saphenous veins, but visceral venous aneurysms are rare. These aneurysms most commonly arise from the main portal vein and the confluence of the splenic and superior mesenteric veins. There have been fewer than 50 reported cases of portal venous aneurysm. Evaluation involves imaging modalities such as ultrasound, CT, magnetic resonance imaging (MRI), and angiography. There is currently no clear guideline for management, but options include observation, resection, thrombectomy, or portal venous decompression.
Copyright© South Dakota State Medical Association.