CASE REPORT Splenic vein aneurysm: a rare clinical entity Amit Gupta & Madhu Kumar Singhal & Ravishanker Pillenahalli Maheshwarappa & Mangi Lal Meena Received: 12 April 2012 / Accepted: 23 April 2012 / Published online: 26 June 2012 # Indian Society of Gastroenterology 2012 Abstract A 52-year-old man presented with complaints of generalized malaise along with pain in left hypochondrium and diarrhea. The color Doppler and subsequent contrast enhanced CT scan revealed changes of portal hypertension and saccular dilatation of splenic vein along with partial thrombus in portal vein and superior mesenteric vein. Keywords Aneurysm . Splenic . Splenic vein Introduction Aneurysm is defined as abnormal dilatation of vessel wall. Aneurysm in the portal venous system is a rare finding and splenic vein aneurysm (SVA) still rarer. We present a case of an incidentally found splenic vein aneurysm with partial portal vein thrombus in a patient of portal hypertension. Case report A 52-year-old man was admitted to our hospital with com- plaints of generalized malaise, pain in the left hypochondrium, and diarrhea since 3 months. The patient had regularly con- sumed significant amounts of alcohol in the last 10 years. The gray scale ultrasound revealed shrunken liver, significantly enlarged spleen and a cystic lesion in the epigastric region posterior to the pancreatic body. The portal vein appeared dilated. Upper gastrointestinal endoscopy revealed esophageal varices. On color Doppler the mid part of the splenic vein showed a saccular dilatation measuring 27 mm in diameter (Fig. 1). Contrast enhanced CT scan confirmed the finding of an aneurysm and revealed partial portal vein thrombus extend- ing into its lobar branches and the superior mesenteric vein. A few venous collaterals and congestive changes in spleen were also noted (Fig. 2). The coronal (Fig. 3) and post processed CT images (Fig. 4) also depicted the abnormality. Discussion Splenic vein aneurysms are exceedingly rare. The first case of splenic vein aneurysm was described by Lowenthal and Jacob in 1953 [1]. Since then very few such cases have been reported. The exact mechanism of development of these aneurysms is not well understood, but could include portal Fig. 1 Gray scale ultrasound image and corresponding color Doppler image showing a globular vascular structure representing splenic vein aneurysm (arrow) A. Gupta (*) : M. Kumar Singhal : R. P. Maheshwarappa : M. L. Meena Department of Radiodiagnosis, Ravindra Nath Tagore Medical College, Udaipur, India e-mail: amitsensation@yahoo.co.in Indian J Gastroenterol (May–June 2013) 32(3):204–205 DOI 10.1007/s12664-012-0181-5