Case Report
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World J Hepatol. Dec 27, 2012; 4(12): 406-411
Published online Dec 27, 2012. doi: 10.4254/wjh.v4.i12.406
Complications arising in simple and polycystic liver cysts
Christian Macutkiewicz, Ricci Plastow, Melissa Chrispijn, Rafik Filobbos, Basil A Ammori, David J Sherlock, Joost PH Drenth, Derek A O'Reilly
Christian Macutkiewicz, Ricci Plastow, Basil A Ammori, David J Sherlock, Derek A O'Reilly, Department of Hepato-Pancreato-Biliary Surgery, North Manchester General Hospital, Manchester M8 5RB, United Kingdom
Melissa Chrispijn, Joost PH Drenth, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, PO Box 9101, Code 455 Nijmegen, The Netherlands
Rafik Filobbos, Department of Radiology, North Manchester General Hospital, Manchester M8 5RB, United Kingdom
Basil A Ammori, Derek A O’Reilly, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
Author contributions: Macutkiewicz C, Plastow R and Chrispijn M provided a first draft of case reports; Filobbos R, Ammori BA, Sherlock DJ, Drenth JPH and O’Reilly DA provided additional information and critical revision; and all authors approved the final manuscript.
Correspondence to: Derek A O’Reilly, Consultant Hepatobiliary and Pancreatic Surgeon, Department of Hepato-pancreato-Biliary Surgery, North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester M8 5RB, United Kingdom.
Telephone: +44-161-7202277  Fax: +44-161-7202228
Received: November 17, 2011
Revised: August 14, 2012
Accepted: November 14, 2012
Published online: December 27, 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 cava obstruction was managed by cyst aspiration and lanreotide; 1 patient with common bile duct obstruction was first managed by endoscopic retrograde cholangiopancreatography and stenting, followed by open fenestration; 1 patient with ruptured cysts and significant medical co-morbidities was managed by percutaneous drainage; 1 patient with portal vein occlusion and varices was managed by open liver resection; 1 patient with infected cysts was treated with intravenous antibiotics and is awaiting liver transplantation. The final patient with a simple liver cyst mimicking a hydatid was managed by open liver resection. In conclusion, complications of cystic liver disease are rare, and we have demonstrated in this series that both operative and non-operative strategies have defined roles in management. The mainstays of treatment are either aspiration/sclerotherapy or, alternatively laparoscopic fenestration. Medical management with somatostatin analogues is a potentially new and exciting treatment option but requires further study.

Keywords: Liver, Cysts, Complications, Polycystic