Abstract
BackgroundThe spontaneous rupture of nonparasitic liver cysts (NLC) is sometimes seen in clinical practice. However, there are no guidelines that describe the optimal treatment strategy and the surgical indications for an NLC rupture due to a small number of reports. Here, we present a case who underwent elective laparoscopic deroofing to treat a spontaneously ruptured NLC that had undergone conservative treatment.Case presentationA 67-year-old woman was referred to our hospital for the evaluation of acute abdominal pain after the conservative treatment of an NLC at another hospital. She had stable vital signs and no abdominal rigidity. We performed an elective laparoscopic deroofing following an examination of the cyst relative to the bile ducts and the patient’s general condition. Computed tomography (CT) and magnetic resonance imaging (MRI) showed that there was no solid mass in the cyst. During the laparoscopic surgery, the cyst wall was resected and the back wall of the cyst was incinerated using an inverse-opal-structure electrode. The patient’s postoperative course was stable without any complications.ConclusionsWe succeeded the conservative therapy and the elective laparoscopic surgery for ruptured of NLC. However, elective surgery in spontaneously ruptured NLC with intraabdominal infection or hemorrhage is still challenging.
Highlights
The spontaneous rupture of nonparasitic liver cysts (NLC) is sometimes seen in clinical practice
We have described a rare case of elective laparoscopic deroofing for the treatment of an NLC that ruptured spontaneously after conservative treatment
Ruptures of parasitic liver cysts tend to be caused by Echinococcus species, they are known complications associated with these cysts, and they are reported as hydatid cyst ruptures [5, 6]
Summary
Nonparasitic liver cysts (NLCs) are congenital benign malformations that occur in approximately 1–5% of the general population [1]. Case presentation A 67-year-old Japanese woman was transferred to the emergency unit of our hospital for an evaluation of her acute abdominal pain She had a 2-week history of conservative treatment with antibiotics for an NLC at another hospital (Fig. 1a). The patient’s pulse rate was 80 beats/ min, her blood pressure was 136/68 mmHg, and she did not have a fever Based on the patient’s clinical course and the findings from the investigations, we determined that the ruptured NLC had not induced acute peritonitis; the patient received the antibiotics therapy (cefmetazole 3 g/day) prior to the surgery and was performed an elective laparoscopic deroofing after the patient’s general condition was assessed.
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