Aneurysm of portosystemic fistula: A case report and review of literature

Abstract

Aim: A case of asymptomatic aneurysm of spontaneous portosystemic venous fistula (SPVF) with the radiologicfindings is described.Background: Although advances and more widespread use of ultrasound (US) and computed tomographyangiography (CTA) have enabled more detection of SPVF in the liver, it is a rare entity.Case report: A 49-year-old male was referred to our hospital’s nephrology outpatient clinic due to hypertension. Abdominal sonography examination detected a well-defined cystic lesion adjacent to the middle hepaticvein in the liver. The lesion showed venous flow in the color Doppler US examination. Computed tomographyangiography examination revealed an aneurysm of the fistula.Conclusion: Radiologists should be aware of this vascular anomaly and cyst-like lesions in the liver shouldbe examined with color Doppler ultrasonography for possible vascularization, and be differentiated with CTAif necessary.Clinical significance: This condition is usually encountered incidentally and patients usually have no symptoms. However, severe complications, such as hepatopulmonary syndrome, liver tumors, encephalopathy, andheart failure can be seen.