A case of extra-hepatic portal vein aneurysm: evaluation by 3-dimensional computerized tomography angiogram

Portal vein aneurysms (PVAs) are rare lesions associated with congenital vascular anomalies or chronic portal hypertension. Although usually benign, they occasionally lead to complications such as aneurysmal rupture, porto-systemic shunts, mural thrombosis in the portal vein, and compression of the biliary tract. So far, the diagnosis of these lesions has been dependent on 2-dimensional imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI), or invasive procedures such as percutaneous transhepatic portography. Here we present the first documented case of an extra-hepatic portal vein aneurysm evaluated by 3-dimensional CT angiography. This easily performed and accurate imaging technique may obviate the need for invasive angiographic procedures in the future for the 3-dimensional characterization of deep vascular malformations in the portal circulation.