Haemorrhagic rupture of hepatic simple cysts (original) (raw)
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Ruptured Hemorrhagic Hepatic Cyst: An Unusual Case Report
GE - Portuguese Journal of Gastroenterology
Background: Hemorrhagic rupture of a hepatic cyst is rare. To date, very few cases have been reported in the literature. Case Report: A patient with a history of a suspected liver hydatid cyst presented to the emergency department with abdominal pain and fever. She was admitted with the presumptive diagnosis of acute cholecystitis. During hospitalization, the patient presented with hemodynamic instability and abrupt worsening of the abdominal pain. The abdominal angio-chemotherapy scan showed an abundant free peritoneal effusion and an apparent effacement of the anterior wall of a hepatic cyst of 16 cm. The patient underwent an exploratory laparotomy, deroofing of the cyst, and peritoneal lavage. The anatomopathological results showed a simple hepatic cyst. Discussion: Hemorrhagic rupture of simple hepatic cysts is a life-threatening complication and, although rare, should be included in the differential diagnosis of sudden abdominal pain in patients with a history of simple hepatic cysts.
Traumatic rupture of a hemorrhagic hepatic cyst: a case presentation and literature review
Journal of surgical case reports, 2021
Hemorrhagic hepatic cyst with or without rupture is rare cause of acute abdomen with less than 20 cases reported in the literature. A standardardized management algorithm is currently not present, but literature suggests surgical management is ideal for definitive treatment and successful patient outcome. We report a case of a 39-year-old female with a chief complaint of sudden onset abdominal pain, nausea and vomiting. Abdominal computed tomography scan showed a large, 12-cm cyst in the right hepatic lobe with a hemorrhagic component. Successful laparoscopic operative management was conducted without post-operative complications such as recurrent bleeding. When managing patients with an acute abdomen, ruptured hepatic hemorrhagic cysts should be considered in the differential diagnosis and prompt surgical management should be considered as primary management.
Journal of Gastrointestinal Surgery, 2012
Objective Hemorrhage within a hepatic cyst (hemorrhagic hepatic cyst, HHC) is a complication of liver cysts that is difficult to differentiate from other neoplastic entities on imaging. Even when accurately diagnosed, there has been a lack of consensus on the optimal treatment strategy. After presenting our experience with a patient treated via laparoscopy, we aimed to conduct a review of the literature on HHCs. Methods A computerized search in Medline, PubMed, Google Scholar, and The Cochrane Collaboration was carried out for journal articles or abstracts published from 1950 to 2011. Results A total of 24 patients with HHCs were identified from 1983 to 2011. The cohort had an even gender distribution with a mean age of 62.7 years. Most patients presented with abdominal pain (80 %), while three (14 %) patients were asymptomatic at the time of presentation. CT imaging and ultrasound were unable to accurately diagnose HHC, whereas hyperintensity on MRI was a reliable diagnostic tool. Three (13 %) patients were managed conservatively with observation. Seven (30 %) patients had percutaneous transhepatic drainage. Among these, two patients experienced recurrence that required repeat treatment. Two (9 %) patients underwent open unroofing of their HHC and one (4 %) laparoscopically, without recurrences. Seven (30 %) patients underwent hepatic resection, whereas six (26 %) patients had a cyst enucleation for their HHCs. All patients had uneventful recoveries, with a mean follow-up of 25 months. Conclusions MRI is a reliable diagnostic tool in the setting of an HHC. Laparoscopic unroofing of HHCs may represent a less morbid and safe treatment modality with low recurrence rates. Given the low level of clinical evidence available so far, these results should be interpreted with caution.
Spontaneous rupture of a giant non parasitic hepatic cyst presenting as an acute surgical abdomen
Annals of hepatology
Spontaneous rupture of a non parasitic hepatic cyst is an extremely rare occurrence. A 50 -year- old male, was admitted with typical clinical manifestations of acute surgical abdomen. At exploratory laparotomy, a giant ruptured non parasitic cyst occupying the entire left liver lobe was found, along with a large amount of free intraperitoneal fluid. The cyst was widely unroofed very close to the liver parenchyma. The patient had an uneventful postoperative course and was discharged six days later. The clinical presentation, diagnostic evaluation and surgical management of this extremely rare clinical entity are discussed, along with a review of the literature. This case, which according to our best knowledge is the fourth reported in the literature, highlights the considerable risk of serious complications associated with the presence of a large symptomatic nonparasitic hepatic cyst. Prophylactic treatment should be considered in all these cases.
Spontaneous rupture of a large non-parasitic liver cyst: a case report
Journal of Medical Case Reports, 2010
Introduction: Non-parasitic hepatic cysts are benign entities, occur rarely (5% of the population), and in the majority of cases, are asymptomatic. Cysts can cause symptoms when they become large and produce bile duct compression or portal hypertension, and also when complications such as rupture, infection or hemorrhage take place. Case presentation: We present the case of a 70-year-old Greek-Caucasian man with a large, asymptomatic and non-parasitic liver cyst that presented as an acute surgical abdominal emergency after spontaneous rupture into the peritoneal cavity. Conclusions: We present an extremely rare complication of simple liver cyst, its rupture in the free abdominal cavity, and its presentation as an acute abdomen. Large simple liver cysts should be treated with intervention at early recognition as conservative management usually results in their recurrence.
Complications arising in simple and polycystic liver cysts
2012
Liver cysts are common, affecting 5%-10% of the population. Most are asymptomatic, however 5% of patients develop symptoms, sometimes due to complications and will require intervention. There is no consensus on their management because complications are so uncommon. The aim of this study was to perform a collected review of how a series of complications were managed at our institutions. Six different patients presenting with rare complications of liver cysts were obtained from Hepatobiliary Units in the United Kingdom and The Netherlands. History and radiological imaging were obtained from case notes and computerised radiology. As a result, 1 patient admitted with inferior vena
Case Report of Large Simple Hepatic cyst
IOSR Journals , 2019
Most liver cysts are benign, even though early diagnosis plays vital role for proper treatment of parasitic or cancerous subtypes. Simple hepatic cysts may be isolated or multiple and may vary from a few millimeters to several centimeters in diameter. Giant cysts of the liver are uncommon. A 60 years female patient was malnourished and pale. Vitals were stable. On per abdomen examination, a mass felt in right hypochondria region extended up to right lumbar region associated with tenderness, firm in consistency. On percussion it was dull. CT scan revealed a large hypodense lesion in segment VI & VII completely replacing and compressing the right lobe of liver, measuring approximately 21 X 13 cm. No evidence of obvious calcifications. During surgery, large hepatic cyst was noted involving right lobe and left lobe of liver and right dome of diaphragm. Falciparum ligament appears thinner than usual. From this hepatic cyst 2.5 liters of fluid was drained out. Histopathological findings noted were cyst wall showing fibrous tissue, lymphocytes, small ducts lined by cuboidal epithelium and few hepatocytes attached to cyst wall suggestive of simple hepatic cyst. Accurate diagnosis will help for prompt management. Even though most of the hepatic cysts are benign, better to undergo investigations such as CT, Histopathology examination to rule out differential diagnosis and to alleviate any further complications.
Simple Hepatic Cyst: A Case Report
The term hepatic cyst usually refers to solitary non-parasitic cysts of the liver also known as simple cysts.The most common benign lesion found in the liver is the congenital or simple cyst. They are believed to be congenital in origin. Asymptomatic simple cysts are best managed conservatively. The preferred treatment for symptomatic cysts is ultrasound or CT-guided percutaneous cyst aspiration followed by sclerotherapy. If percutaneous treatment is unavailable or ineffective, treatment may include either laparoscopic or open surgical cyst fenestration. Unroofing of the extrahepatic portion of the cyst may be done.We report a case of simple hepatic cyst that presented with abdominal pain and its management.
Management of Nonparasitic Hepatic Cysts
Journal of the American College of Surgeons, 2009
BACKGROUND: The optimal management of nonparasitic hepatic cysts (NPHC) is a topic of debate. The purpose of this study was to evaluate our 17-year experience with NPHC. STUDY DESIGN: From consecutive patients with NPHC were evaluated and treated at our institution. Seventy-eight patients (60%) had simple hepatic cysts (SHC). The remaining 53 (40%) had polycystic liver disease (PLD). Morbidity, mortality, and recurrence rates for each of the two groups were evaluated.