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Editor’s quiz: GI Snapshot

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From question on page 937

The computed tomography (CT) scan showed a high signal intensity mass over the hilum of the liver compatible with aneurysmal dilatation of the portal vein. The biliary system, hepatic parenchyma, and spleen were normal (fig 1).

An extrahepatic portal vein aneurysm was confirmed in the spiral CT angiography as a homogeneous contrast enhancing lesion near the junction of the superior mesenteric vein and the splenic vein. In this case, a conservative management strategy was adopted, with regular review of the size of the aneurysm. At present, she is healthy and has developed no complications.

Portal vein aneurysm is a very rare entity with no more than 50 cases published. Despite the fact that the postulated origins seem to be controversial, its relation to portal hypertension has been emphasized. Although there is no consensus on treatment, management includes careful follow up in asymptomatic patients without underlying liver disease or portal hypertension.

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