Percutaneous drainage of an infected hepatic cyst, responsible for obstructive jaundice by compression on the intrahepatic biliary tract

Abstract

Hepatic cysts consist of a heterogeneous group of lesions that differ in etiology, prevalence, and clinical manifestations. Liver cystic lesions fall into two main categories: congenital and acquired. Congenital cystic lesions of the liver include polycystic liver disease, simple cysts, ciliated and duct-related liver cysts. Acquired liver cysts are further divided into infected and non-infected. There are two types of infected cysts, parasitic ones (hydatid cysts and amoebic abscesses) and non-parasitic ones, or pyogenic liver abscesses. Infection is a serious complication of cystic liver disease, which can lead to sepsis and death. A diagnosis of cystic infection is usually made by culturing pathogens from the fluid aspirated from the cyst. If an aspirate is not available for testing, the diagnosis of a liver cyst complicated by infection is made by correlating clinical, biochemical, and imaging findings. Infected liver cysts and liver abscesses can be caused by the portal spread of intra-abdominal infections (e.g., appendicitis, diverticulitis, colitis). The placement of a percutaneous drainage catheter allows controlled aspiration of large abscesses for a short-medium period with minimal hemodynamics and physiological stress for the patient. Furthermore, compared to surgical drainage, the results are comparable, while the morbidity is lower.