Management of a Giant Hepatic Cyst by Total Cyst Enucleation in Uganda. A Case Report and Review of Literature

Abstract

Introduction: Giant hepatic cysts are uncommon and cause symptoms due to compression effects. Symptoms include early satiety, abdominal discomfort, abdominal mass and rarely pain in case of haemorrhage, rupture or cyst infection. Aetiology is unknown but liver cysts are thought to be congenital. Management if liver cysts is debatable but options include sclerotherapy, fenestration or deroofing, open or laparoscopic partial or total cyst excision, cyst enucleation and rarely liver resection. There is paucity of data on management of Giant liver cysts in Uganda and the East African region and to the best of our knowledge, this is the first reported case in our country and region. Method: We present a sixty one year old female Ugandan who was admitted due to an increasing abdominal mass with associated discomfort and early satiety. Contrasted abdominal computed tomography (CT) scan revealed a 28 x 26 cm simple liver cyst. Results: She underwent open total cyst enucleation after initial cyst decompresion. Postoperative recovery was uneventful and she was discharged on the 8th postoperative day. Conclusion: It is easier to perform a total cyst excision or enucleation for Giant liver cyst with a thick wall or cyst capsule. Figure 1: Abdominal CT scan of the giant liver cyst (top left), intraoperative intact cyst (top middle), cyst dissection (top right), detaching cyst from inferior vena cava (bottom left), atrophied right lobe and hypertrophied left lobe (bottom middle), after total cyst excision/enucleation (bottom right)