Dear David,
recently, a smiliar patient was refered to our department. The patient was diagnosed with portal vein thrombosis and portal vein aneurysma of 6.5 cm. He presented with variceal bleeding and endoscopic band ligation (EBL) was performed. After another variceal bleeding, we discussed TIPS implantation. During the intervention, we were able to insert a wire into the portal vein, however, we were not able to pass the aneurysma into the splenic vein or the vena mesenterica inferior and we were not able to insert a TIPS stent. Further, after varices had sufficiently been treated with EBL, we started oral anticoagulation. During follow-up CT scans, the thrombosis decreased and the aneurysma shrinked to a diameter of 1,9 cm. During last upper GI endoscopy, the patient showed varices grade I.
If you are interesed, we could share characteristic CT scans.
Best wishes,
Dominik Bettinger
University Medical Center Freiburg, Germany