Intrahepatic portal vein aneurysm complicating severe portal hypertension: a case report

Portal vein aneurysms (PVA) are rare vascular anomalies, often associated with liver cirrhosis or portal hypertension. We report the case of a 40-year-old woman admitted for upper gastrointestinal bleeding due to ruptured esophageal varices. Imaging revealed a saccular intrahepatic portal vein aneurysm measuring 23 x 22 mm with a 16 mm neck, partially thrombosed and extending to the superior mesenteric vein. The final diagnosis was intrahepatic portal vein aneurysm complicating severe portal hypertension secondary to chronic hepatitis B. Conservative management was adopted. This case illustrates the value of Doppler ultrasound and CT in detecting intrahepatic PVA and highlights the association between acquired aneurysms and severe portal hypertension.