Abstract

The authors present a case of a sixty-nine-year-old woman who had a saccu lar aneurysm of the extrahepatic portal vein measuring 5 cm in diameter. The aneurysm was excised safely without complications. Microscopically, the aneu rysmal wall showed extremely thin portions with media consisting of only a few layers of muscle bundles. Etiology was considered to be congenital. Eighty cases have been reported in the world literatures including 40 cases presented in Japanese. Fatal complications such as rupture and perforation have been reported in 1 case, and portacaval shunt has been recommended as a surgical treatment of choice for symptomatic patients to avoid thrombosis in the aneurysm, rupture, or portal hypertension. On the basis of the experience ob tained from the presented case, however, the authors consider that a large sac cular extrahepatic portal vein aneurysm had better be excised to avoid potentially fatal complications.

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