Abstract
We herein describe a case involving spontaneous rerupture of a nonparasitic liver cyst successfully treated with cyst fenestration and an omental flap. A 59-year-old Japanese woman was transferred to our hospital for evaluation of acute abdominal pain. She had a history of conservative treatment with antibiotics for spontaneous rupture of a liver cyst 1 month previously. On arrival, she exhibited abdominal tenderness and muscular defense. Enhanced computed tomography showed ascites and a large ruptured hepatic cyst (diameter of 10 cm). We diagnosed rerupture of a liver cyst and performed laparotomy for cyst fenestration and intraperitoneal drainage. During the operation, we found the perforation site on the ventral side of the cyst and brown, muddled ascitic fluid. Cholangiography showed no bile leakage on the inner wall. Pathological investigation revealed no evidence of malignancy. The patient recovered without any adverse events and was discharged on postoperative day 8. No recurrences or complications occurred for 2 years.
Highlights
A nonparasitic liver cyst (NLC) is a common benign liver disease
The frequency is unknown, but Morgenstern [5] stated that only four cases of rupture are present among approximately 250 reports of solitary NLC published before 1958
In our computerized search of Englishlanguage reports of NLC rupture published from 1959 to 2013, we identified only 17 publications describing NLC rupture (Table 3) [3–19]
Summary
A nonparasitic liver cyst (NLC) is a common benign liver disease. It is potentially asymptomatic and is often incidentally diagnosed with abdominal imaging such as ultrasonography or computed tomography (CT). We describe a rare case of spontaneous rerupture of an NLC that had become exacerbated after conservative treatment and was successfully treated with surgical fenestration. The frequency is unknown, but Morgenstern [5] stated that only four cases of rupture are present among approximately 250 reports of solitary NLC published before 1958. We presented a case of the second rupture without a specific cause such as infection or trauma after previous conservative treatment. In our case, the slight bleeding in the ruptured NLC could exist, and it might be the reason why the patient exhibited the acute abdomen.
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