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Obstructive jaundice caused by a huge liver cyst riding on the hilum: report of a case
T Kanai1, T Kenmochi, T Takabayashi
1Department of Surgery, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan.
Insights
A large liver cyst caused obstructive jaundice in a patient. Initial drainage relieved symptoms, but recurrence led to successful surgical deroofing, resolving the jaundice.
Area of Science:
- Hepatology
- Gastroenterology
- Surgical Oncology
Background:
- Obstructive jaundice can arise from various causes, including rare hepatic lesions.
- Large liver cysts, particularly those centrally located at the hepatic hilum, are infrequently reported causes of biliary obstruction.
Observation:
- A 71-year-old male presented with obstructive jaundice due to a massive, centrally located liver cyst compressing the hepatic hilum.
- Initial percutaneous transhepatic cyst drainage temporarily relieved jaundice by decompressing the bile duct.
Findings:
- Recurrence of jaundice post-drainage removal indicated the need for definitive treatment.
- Surgical deroofing of the liver cyst resulted in complete resolution of jaundice and sustained patient well-being.
Implications:
- This case highlights the potential for large, centrally located liver cysts to cause significant obstructive jaundice.
- Percutaneous drainage offers temporary relief and diagnostic utility, but surgical deroofing is crucial for preventing recurrence.
- Early recognition and appropriate management of such rare hepatic cysts are essential for favorable patient outcomes.
Abstract:
A 71-year-old man presented to our hospital with obstructive jaundice, found to be caused by a huge liver cyst which was centrally located and riding on the hilum. Percutaneous transhepatic cyst drainage was performed, following which obstruction of the bile duct was relieved and the jaundice subsided. As jaundice recurred after removal of the drainage tube, the patient underwent deroofing, since when he has remained well. Only 13 cases of liver cysts producing obstructive jaundice have been reported in the English literature, most of which were characteristically enormous, located centrally, and riding on the hilum. Liver cysts possessing such features are likely to cause obstructive jaundice by compressing the hepatic hilum. Cyst drainage is helpful for ameliorating the jaundice and making an accurate diagnosis; however, subsequent deroofing or injection therapy is necessary to prevent recurrence.