Question:

Regarding portal venous aneurysm:
1. Most are extrahepatic
2. Most are asymptomatic
3. They may present as non-specific abdominal pain
4. Portal venous pseudoaneurysms represent focal dilatations of the portal venous system
5. Are more common following trauma than hepatic artery aneurysm





Answer:

The correct answers for the question "Regarding portal venous aneurysm: " are:

2. Most are asymptomatic

3. They may present as non-specific abdominal pain



Explanation
1.    Most involve the main portal vein or intrahepatic branches (The most common location for portal vein aneurysms and pseudoaneurysms is the main portal vein and branching sites of the intrahepatic portal vein though extrahepatic portal vein aneurysms have been reported).

2.    Portal venous aneurysms are usually asymptomatic unless complications arise (Most aneurysms of the portal vein are asymptomatic though they may cause non-specific abdominal pain).

3.    True (Most aneurysms of the portal vein are asymptomatic though they may cause non-specific abdominal pain).

4.    This is the description of a portal venous aneurysm. In contrast a pseudoaneurysm is a haematoma (Rather than being a focal dilatation of a vessel, a pseudoaneurysm is a pulsatile haematoma that results when blood leaks beyond a tear or disruption in the vessel wall and forms a haematoma.)

5.    Portal venous aneurysms are rare than hepatic arterial aneurysms following trauma (In the context of trauma, hepatic artery aneurysms have a prevalence of less than 1%. A recent study of over 4,000 consecutive patients suggested a prevalence of less than 0.4%).



From the manuscript:
Blunt abdominal trauma An important cause of portal venous pseuodoaneurysm
Radiology Case. 2010 May; 4(5):27-31


This article belongs to the GI section.




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From the manuscript

Blunt abdominal trauma An important cause of portal venous pseuodoaneurysm

Free full text article: Blunt abdominal trauma  An important cause of portal venous pseuodoaneurysm

Abstract
Aneurysms and pseudoaneurysms of the portal venous system are rarely seen following abdominal trauma but clinicians need to be aware of them as possible vascular complications following blunt trauma. This case report of a 10 year old boy following a handlebar injury demonstrates a clear causal relationship between trauma and portal venous pseudoaneurysm. Portal venous aneurysms have a prevalence of less than 0.4% and most are found in patients with underlying hepatocellular disease. Many are asymptomatic in which case surveillance is an accepted management strategy, with Doppler ultrasound proving useful. Complications including thrombosis, distal embolism, compression of the biliary tree and haemorrhage are usually indications for surgical management. Portal venous pseudoaneurysms may be managed conservatively but transcatheter embolisation can be used if there are ongoing complications or haemorrhage.






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