Clinical Manifestations of Symptomatic Hepatic Cysts and Ethanol Sclerotherapy

Abstract

Background : Most hepatic cysts are asymptomatic liver disease. Rarely, hepatic cysts will be symptomatic because ofincreasing size, infection and hemorrhage. We describe clinical characteristics of symptomatic hepatic cysts and its effectivetreatment.Methods : We performed a retrospective review of all patients diagnosed with symptomatic hepatic cysts between May 2009and April 2013 in Jeju National University Hospital. Twenty one symptomatic hepatic cysts (mean 10.7cm) in 14 patients (12women and 2 men, aged 51 to 81 years) were enrolled.Results : Symptoms of hepatic cysts were right upper abdominal pain (10 patients), recurrent lower extremities edema (2patients), fever (3 patients), and right shoulder radiating pain (1 patient). All symptomatic hepatic cysts were treated withpercutaneous drainage (mean volume 480 ± 325 ml, max 1250 ml). Three infected cysts were diagnosed by cystic fluidanalyses and treated using antibiotics. After drainage, 20 hepatic cysts were treated with 99.9% ethanol sclerotherapy for threedays. There were few minor complications including pain, nausea, vomiting. During follow-up (11 months), there was norecurrence. The mean diameter of remained cysts decreased to 3.2 cm with an average volume reduction rate of 92.3 % (from464.1 cm3 to 35.8 cm3).Conclusions : Percutaneous drainage and ethanol sclerotherapy is a very effective and safety treatment method ofsymptomatic hepatic cysts.