CT of the portal vein after portacaval shunt with arterialization

Objective: Our goal was to assess the state of the portal vein in cirrhotic patients treated with a portacaval shunt associated with an arterialization of the portal vein. Materials and Methods: We reviewed the follow-up CT of 23 patients treated by portacaval shunt with arterialization of the portal vein. Results: Five patients demonstrated an aneurysm of the portal vein. Followup Studies revealed progression of the aneurysm and development of a mural thrombosis in four patients. The thrombosed portal vein was calcified in three patients. One patient demonstrated a dilatation of the saphenous vein graft in addition to the portal vein aneurysm. Only one of the five patients was symptomatic, presenting with ascites, dilatation of intrahepatic biliary ducts, and jaundice secondary to the compression of hilar structures by the huge portal vein. Conclusion: Aneurysm of the portal vein following portacaval shunt associated with arterialization of the portal vein is not a rare complication.