Superior mesenteric vein aneurysm: A case report with 2-year follow-up

Abstract

Visceral venous aneurysms (VVAs) are rare, accounting for 3% of all venous aneurysms. We present a case of a 73-year-old man diagnosed with an incidental 3.3 cm superior mesenteric vein (SMV) aneurysm, which has been managed conservatively for over 2 years. A 73-year-old man presented to the emergency department with a 1-week history of abdominal pain, generalized fatigue, and multiple episodes of vomiting. A contrast-enhanced computed tomography scan of the abdomen and pelvis was performed. This demonstrated an incidental multilobulated SMV aneurysm at the level of the inferior aspect of the uncinate process of the pancreas, with a maximal diameter of 25 mm. We have successfully managed this conservatively with serial imaging for 2 years. There are only 17 reported cases of SMV aneurysms, most of which occur at the confluence of the splenic vein. Ours occurred in the distal SMV. Due to their rarity, there is no standardized management approach for VVAs. Treatment is only proposed for VVAs with increasing size or rupture, thrombosis, or compression of local structures. We provide our experience in successfully managing an uncomplicated SMV aneurysm conservatively.

Keywords

• aneurysm
• superior mesenteric vein aneurysm
• visceral venous aneurysms