Giant Hepatic Cyst Complicated by Traumatic Rupture

Abstract

Introduction: Hepatic cysts are formations with liquid-serous content surrounded by normal liver parenchyma and without communication with the intrahepatic bile duct. It is reported with higher incidence in adults over fifty years of age, with a women/men ratio of 1.5: 1. They are asymptomatic; symptoms appear due to either their size or the presence of complications such as hemorrhage, rupture, intracystic infection, or compression of adjacent structures.

Objective: To characterize a patient with a giant hepatic cyst complicated by traumatic rupture.

Clinical case: A 81-year-old female patient went to the emergency room after falling and subsequently impacting herself on a hard surface at the level of the rib cage and right hypochondrium; she presented intense abdominal pain accompanied by nausea and vomiting. The physical examination showed clear signs of peritoneal irritation. A computerized axial tomography was performed, reporting rupture of the hepatic cyst wall and approximately 600 mL of free fluid within the cavity. Emergency surgical treatment was performed after cyst unroofing and cavity washing.

Conclusions: Hepatic cysts, due to their size or complications, can endanger the patients’ lives. It is necessary for the surgeon to consider knowledge of this condition as part of his or her diagnostic resources.

Keywords: simple hepatic cyst; giant hepatic cyst; complications of hepatic cysts; cyst unroofing.