Abstract
A 48-year-old female patient was found to have a paraumbilical vein saccular aneurysm, which is a rare consequence of portal hypertension. She presented with right upper quadrant pain and had a known diagnosis of alcoholic liver disease. This had progressed since her last admission. We discuss the multimodality images obtained, diagnosis and complications associated with this pathology.
Highlights
Differential diagnosisPancreatic aneurysm Hepatic cirrhosis with varices Paraumbilical vein aneurysm
Clinical presentation A 48-year-o ld female patient with a known alcoholic liver disease history, presented to St Mary's Hospital, Isle of Wight with right upper quadrant pain
The lesion was seen to arise from a recanalised paraumbilical vein (Figure 5), which is a branch of the left portal vein
Summary
Pancreatic aneurysm Hepatic cirrhosis with varices Paraumbilical vein aneurysm. A Siemens SOMATOM Definition AS 128 row CT pancreas was arranged to better assess the contents of the high T2 signal lesion and, see if it was of vascular origin. The dual phase contrast-enhanced CT scan of the upper abdomen showed a 38 × 30 mm lesion, which was anterior to the pancreas and discrete from the medial wall of the stomach and liver and segment D1 of the duodenum (Figure 4). The lesion was seen to arise from a recanalised paraumbilical vein (Figure 5), which is a branch of the left portal vein. A previous CT from 2 years earlier showed a smaller, 10 mm, lesion in a similar location arising from a dilated paraumbilical vein (Figure 6). The above findings are consistent with this lesion representing a recanalized paraumbilical vein saccular aneurysm, which is increasing in size.
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