Hepatic cyst is a nonparasitic cyst formed in the liver. These cysts are also called simple cysts. The cyst forms as a bubble having a thin wall. Usually, the cyst is filled with fluid but sometimes it may not have fluid. The liver cyst does not cause health problems and are benign. When the cyst becomes big in size, it may cause abdomen pain along with discomfort.
The cyst becomes infected and may cause liver enlargement. It may also cause problems of the bile duct like infection and obstruction. A liver cyst is detected by tests like ultrasound and CAT scanning. Some patients have polycystic liver disease sand hydatid cysts.
Causes Of Hepatic Cysts
The cause of hepatic cyst is not known. According to some experts, the hepatic cyst may form at birth. The cyst may form due to some conditions like Caroli’s disease. This condition is related to bile duct inflammation and dilatation. The condition can also be due to stone formation. Another cause of hepatic cyst is congenital hepatic fibrosis, which is a rare hereditary disease. Hepatic cyst can also be due to choledochal cysts, which is a bile duct abnormality that occurs at the time of birth.
Medical Treatment Of Hepatic Cyst
Medical therapy is not effective in decreasing the simple cyst size. Some patients may benefit from aspiration as well as alcohol sclerosis. However, these procedures may not give results in many patients. Sclerosis is successful if the cyst is decompressed completely. However, the procedure fails when if the cyst wall is thick. It also fails when the size of the cyst is big.
Percutaneous catheters are not suitable for draining simple cyst due to the contamination of the cavity, which leads to the formation of hepatic abscess. Resolution of this problem cannot be done by catheter placement, as there is continuous cyst secretion. If the cyst is big in size and causes pain, surgery is done for unroofing the cyst. In this surgery, the cyst wall that touches the liver surface is excised. This surgery is done with the help of a laparoscope.
Medical Treatment Of PCLD And Hydatid Cyst
Medical treatment is not available for the treatment of PCLD, which is also known as polycystic liver disease. Surgery is done if the patient has disabling pain. Surgery helps in decompressing the cystic liver. If the patient has hydatid cyst, PAIR therapy is done where P stands for puncture, A for aspiration, I for injection and R stands for reaspiration. In this technique, a needle is injected in the cyst with the help of ultrasound and aspiration of the cyst fluid is done. The fluid is analyzed and reaspiration is done by using hypertonic saline.
Drainage is done after the procedure by a catheter. Surgery is done if the patient has complicated hydatid cyst. If the patient has hepatic abscess, antibiotics are given and percutaneous drainage is done. Surgical drainage is done if the abscess is not treated with percutaneous drainage.
Complications Of The Treatment
Unroofing simple cysts usually does not result in complications. Sometimes, there can be bile leakage from cyst. This causes fluid collection. In rare cases, it can cause bile ascites. Unroofing and other procedures should be done carefully in patients who have polycystic liver disease as it can cause injury. During the treatment of hydatid cyst, spilling of substances present in the cyst should be avoided.