Giant infected hepatic cyst causing exclusion pancreatitis: A case report

Figure 1 Abdominal ultrasonography images. Multiple cysts, including a giant cyst, can be observed in the liver. The non-uniform hyperechoic region is considered debris inside the cyst (orange circle).

Figure 2 Abdominal dynamic computed tomography (arterial phase) on hospital day 1. A: A contrast effect is observed in the liver parenchyma around the hepatic cyst (orange arrows). There is no ring enhancement indicating an abscess. The maximum cyst diameter is 203 mm; B: Slight dilation of the main pancreatic duct at the pancreatic tail (orange circle).

Figure 3  Simple abdominal magnetic resonance imaging. Fluid-fluid levels (orange arrowheads) from debris in the hepatic cyst. Debris observed as, A: Hyperintensity on a T1-weighted image; B: Hyperintensity on a T2-weighted image; C: Hyperintensity on a diffusion-weighted image; D: Hypointensity on an ADC map.

Figure 4 Simple abdominal computed tomography on hospital day 7. A: Maximum diameter of the hepatic cyst: 219 mm; B: Slight pancreatic enlargement and increased adipose tissue density around the pancreas (orange circle).

Figure 5 Three-dimensional drip infusion computed tomography cholangiography. Drip infusion computed tomography cholangiography shows no organic abnormalities in the common bile duct.

Figure 6 Post-admission course. AMY: Amylase; CRP: C-reactive protein, VCM: vancomycin; MEPM: Meropenem; CMZ: Cefmetazole.