A Case of Congenital Portal Vein Aneurysm-Few and Far between

Portal vein aneurysm is an unusual vascular dilatation of the portal vein, which was first described by Barzilai and Kleckner in 1956, and since then, less than 200 cases have been reported. So, we would like to present our case, a 27-year-old male who presented with left lumbar pain diagnosed with left lower ureteric calculus and had an incidental finding of portal vein aneurysm. It required no treatment, and he was followed up with serial abdominal ultrasound every 6 months, and the patient is doing well without any complications. Hence, conservative management is the best option in the majority of patients. Surgical indication is currently reserved in 10% of cases, which are complicated by rupture, increase in size on surveillance scan, or are otherwise symptomatic; however, post-operative mortality remains extremely elevated.