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Laparoscopic deroofing of a large hepatic cyst to relieve atypical cardiac symptoms
Mihir Rao1, Bishow Karki1, Julie Jeffery1
1Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Insights
A large hepatic cyst caused cardiac symptoms in a woman. Laparoscopic deroofing resolved her shortness of breath and improved her quality of life.
Area of Science:
- Hepatology
- Cardiology
- Gastroenterology
Background:
- A woman in her 60s presented with cardiac symptoms, including chest pain and dyspnea, initially investigated for crescendo angina.
- Incidental echocardiography revealed a large hepatic cyst, prompting referral to a hepato-pancreato-biliary clinic.
Abstract:
A woman in her 60s was referred to the hepato-pancreato-biliary clinic for further assessment of a large hepatic cyst, which was incidentally identified by echocardiography. She was being investigated for possible crescendo angina on the backdrop of a 6-month history of increasing chest pain, shortness of breath, sweating, orthopnoea and paroxysmal nocturnal dyspnoea. Coronary angiography and echocardiography demonstrated normal cardiac physiology. A CT abdomen/pelvis confirmed an 8.5 cm hepatic cyst indenting the posterior and caudate lobes and abutting the inferior vena cava. Nocturnal dyspnoea was attributed to diminished venous return. Due to worsening symptoms and their impact on her job, the patient underwent laparoscopic deroofing of the hepatic cyst. Histopathology confirmed a simple hepatic cyst. In her first postoperative review clinic, 8 months after her initial visit to the cardiology team, the patient was asymptomatic and fully functional with a considerably improved quality of life.
