Nonparasitic Cysts Research Articles

Spontaneous rupture of hemorrhagic hepatic cyst: two case reports

BackgroundSpontaneous rupture of a hemorrhagic hepatic cyst is extremely rare. There is no standard treatment recommended for this condition. We report two cases of hemorrhagic hepatic cysts that spontaneously ruptured and were successfully treated with laparoscopic deroofing. We review the literature and discuss the characteristic features of spontaneous rupture of hemorrhagic hepatic cysts and their treatment.Case presentationThe first patient was an 85-year-old man admitted for sudden-onset right hypochondralgia and fever. Computed tomography revealed a 13-cm hepatic cyst occupying the right lobe of the liver and spontaneous rupture of the cyst. Laparoscopic deroofing was performed and continuous oozing from the cystic wall was found. Histological examination revealed a simple hepatic cyst. The patient was discharged on postoperative day 6. In the second case, a 77-year-old woman who had been followed up for a simple hepatic cyst (13 cm) was admitted for sudden onset of right hypochondralgia. Computed tomography demonstrated a 9.9-cm hepatic cyst occupying segment 4 of the liver. Laparoscopic deroofing was performed and continuous oozing from the cystic wall was observed. Histological examination revealed a simple hepatic cyst. The patient was discharged on postoperative day 6.ConclusionLaparoscopic deroofing was performed in patients with spontaneous rupture of hemorrhagic nonparasitic hepatic cysts.

MINIMALLY INVASIVE METHODS FOR TREATING LIVER CYSTS

Despite current advances in minimally invasive surgery, the diagnosis and treatment of liver cysts of non-parasitic genesis remains a controversial issue.
 The aim of the study is to improve the results of surgical treatment of patients with liver cysts of non-parasitic genesis by complex application of mini-invasive diagnostic and surgical methods.
 Materials and methods: patients were carried out clinical, laboratory, instrumental methods of examination, during which liver cysts were identified. Patients were prescribed painkillers before and after puncture to prevent pain syndrome. Puncture was performed under local anesthesia. After the evacuation of the contents, 96 % ethyl alcohol was injected into the cavity. Pig tail 6 F catheters were used for drainage. The average drainage time for liver cysts is (22 ± 1.6) days. Indications were determined for performing the puncture under the control of sonography, laparoscopic method of treatment. Puncture-draining interventions were performed in 53 patients with non-parasitic liver cysts, of which ultrasound-controlled drainage was performed in 30 patients, and video laparoscopic drainage was performed in 23 patients.
 Results and discussion: postoperative period was more favorable in patients who used percutaneous puncture interventions. Immediately after percutaneous interventions under ultrasound control and from the second day after video laparoscopic operations and patients returned to their usual diet and volume of physical activity.
 Conclusions: thus, minimally invasive methods of surgical treatment of non-parasitic liver cysts have significantly improved the rehabilitation of this group of patients.

Sclerotherapy of Symptomatic Nonparasitic Splenic Cysts: Excellent Long-Term Treatment Response'

Abstract Background Splenic cysts are rare and occur in 0.5 to 2% of the population. They are usually asymptomatic and do not require therapy. In case of symptomatic nonparasitic splenic cysts, potential therapy includes partial splenectomy or laparoscopic cyst de-roofing as well as ultrasound-guided sclerotherapy with 1% polidocanol or 10% sodium chloride (NaCl) as an interventional alternative. So far, single-session sclerotherapy of symptomatic nonparasitic cysts is recommended only if clear-transparent cyst fluid is aspirated. Materials and Methods We report a case series of 17 patients with symptomatic macroscopically turbid nonparasitic splenic cyst fluid who underwent ultrasound-guided fine needle sclerotherapy with either polidocanol ± 10% NaCl (n = 12) or 10% NaCl alone (n = 5) and a follow-up of a maximum of 12 years after first intervention. Clinical, sonographic, and laboratory chemistry data were recorded at baseline and during the follow-up. Results The mean follow-up time was 43.65 ± 40.18 months. At the end of the follow-up, a 79% reduction of cyst size was achieved. The maximum size reduction in the polidocanol group was 76 ± 18% and 84 ± 21% in the sodium chloride group (p >0.05). At the end of follow-up, 15 out of the 17 patients did not have any further symptoms. Despite the cystic fluid being turbid, it was hardly possible to detect a microbiological superinfection. Conclusion Sclerotherapy of splenic cysts leads to a significant size regression in all patients, independent of the sclerotherapy agent used with fewer systemic toxic side effects of polidocanol treatment. It was shown that in a tertiary care center with significant experience, sclerotherapy of splenic cysts is also safe and successful and can lead to a drastic regression of cyst size and symptoms. This shows that interventional therapy is a good alternative to surgical procedures.

Minimally Invasive Partial Spleen Resection Preserving the Lower Pole in Children: A Technical Report on Feasibility and Safety.

Background: Laparoscopic partial splenectomy is a surgical option for removing part of the spleen with a pathological mass in a way that ensures preservation of the spleen's physiological functions. We aimed to evaluate the efficacy and feasibility of this procedure, performed while preserving the blood supply from the left gastroepiploic artery, in children. Materials and Methods: Following institutional review board approval, this retrospective study was conducted on patients who, between January 2015 and December 2019, underwent laparoscopic partial splenectomy with preservation of blood supply from the left gastroepiploic vessels. In the article, we described patient indications for surgery, surgical technique, surgery time, complications, and follow-up outcomes. Results: Eleven patients (mean age: 12.3 ± 3.4 years) underwent laparoscopic partial splenectomy. Indications for surgery included nonparasitic cysts (n = 8), pseudocysts (n = 2), and hamartomas (n = 1). The mean benign mass diameter was 60 ± 22 mm. The mean operative time was 193.2 ± 55.1 minutes. The mean size of the retained lower pole was 31.1% ± 3.8%. There was no conversion to open splenectomy or any significant complication. The mean postoperative stay was 9 ± 0.7 days. No thrombosis of the splenic and portal veins was noted in the follow-up period, and no splenic remnant infarction occurred. Conclusions: Laparoscopic partial splenectomy with preservation of blood supply arising from the left gastroepiploic vessels seems to be safe in children. However, a larger study is needed to confirm our results.

Hepatic echinococcosis: difficulties in diagnosis at the early stages of progression and with complications (literature review)

To demonstrate the possible difficulties in the diagnosis of hepatic echinococcosis, that a specialist in ultrasound diagnostics and a radiologist may encounter in everyday practice, russian and foreign literature as well as our own experience have been reviewed. With high accuracy and specificity of ultrasonography in the differential diagnosis of echinococcal cysts, incorrect interpretation is possible in the presence of mural hemorrhages and (or) hemorrhagic clots in a nonparasitic cyst, which aren’t also visible in ultrasonography and can imitate elements of the chitinous membrane. The degree of prevalence of the process, the exclusion of damage to the lungs and other organs of the abdominal cavity are important. In such cases CT scan is the most convenient and accurate diagnostic method due to its high spatial and temporal resolution, standardization and availability. In the most difficult cases the capabilities of MRI are used in the comparison of diffusion-weighted images and apparent diffusion coefficient, which also makes it possible to diagnose cystic neoplasms. Ultrasonography is a diagnostic technology that is still the most commonly used to differentiate cavity structures; however, all dubious clinical observations should be further examined by using CT or MRI.

Clinical Outcome of Sclerotherapy or Laparoscopic Cyst Excision As Initial Management for Non-parasitic Splenic Cysts in Children

Clinical Outcome of Sclerotherapy or Laparoscopic Cyst Excision As Initial Management for Non-parasitic Splenic Cysts in Children

МЕТОДЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ПАЦИЕНТОВ С НЕПАРАЗИТАРНЫМИ КИСТАМИ СЕЛЕЗЕНКИ

Nonparasitic splenic cysts (NPSCs) are uncommon lesions of the spleen,clinically, they may be asymptomatic. Their classification includes two basic groups: the true cysts or primary cysts and false or pseudo cysts based on the presence or absence of an epithelial lining. The need for surgery of nonparasitic cysts is due to the development of complications: suppuration, hemorrhage into the cavity of the cyst and its rupture. Historically, the conventional surgical method was splenectomy, however, complete removal of the organ, especially at a young age, often led to life-threatening infectious complications. Spleen-preserving surgeryis considered to be analternative to classicalsplenectomy: partial resection of the spleen and fenestration with excisionof extra-hepaticcyst wall. However, as clinical practice has shown, these methods can be effectively used exclusively for the treatment of superficial cysts, and during the operation the ruptures of the capsule of the pathological focus with bleeding are observed. According to the general tendency in surgery to reduce the traumatization all patients were worked up with an ultrasound and X-Ray examination of the abdomen to look for the size and location of the splenic cysts. These operations include: drainage with sclerosing of the cyst and deepithelialization with superselective arterial embolization of the feeding vascular pedicle of the pathological focus. The study of these techniques revealed their weak points: the recurrence rate of cysts after sclerosis was 30-50%, and the use of embolizing agents in 50% of cases is complicated by ischemia of an organ segment with possible formation of an infarction zone in the early postoperative period. Nowadays the most promising method is considered to be a microwave ablation. Its thermal effect creates coagulation necrosis of the pathological focus and surrounding tissues with minimal toxic effects. This approach decidedly requires further research.

The use of endoscopic cryoapplicator in liver and gallbladder surgery

Purpose of the study. To investigate the efficacy of focal destruction tissues of local liver diseases, chole- and hemostasis of created endoscopic cryoapplicator in operations on the liver and gallbladder.Material and methods. Review the results of surgical treatment of 121 patients with various diseases of the liver (tumors, alveococcosis, parasitic and non-parasitic cysts) and gallbladder (chronic and acute cholecystitis) using a new endoscopic porous TiNi cryoapplicator. 49 patients were operated by an open method, 72 - laparoscopically. Hemo-and cholestatic control of the instrument was performed intraoperative and in postoperative period - by clinical condition of patient and by ultrasonography. Efficiency of destruction of focal liver diseases was investigated by histological examinations of surgical materials, is confirmed by the absence of relapses in the period from 4 to 6 years.The results. Cryoapplicator is simple in use, in sterilization, no energy consumption, can be used both in open surgery, particularly in arduous regions of the liver and laparoscopic procedures and, most importantly, patients with artificial cardiac pacemakers.Cryodestruction of the liver stump after its resection and the bed of the gallbladder after cholecystectomy reduces blood loss by 30-40%, and also helps to reduce the number of relapses of the disease. There were not observed bleeding and bile leakage in postoperative period. Histological examination proved picture of avascular necrosis, a violation of tissue structure of subjected to destruction liver focal diseases, death of epithelial lining of non-parasitic cysts and membranes of echinococcal cysts. There were not diseases recurrences in the period from 4 to 6 years.Conclusion. Endoscopic porous TiNi cryoapplicator is simple and convenient in use, it has a good hemo- and cholestatic effects, pronounced effect to local destruction of liver focal diseases, can be recommended for open and laparoscopic operations on liver.

Large expanding splenic pseudocyst: A case report and review of literature.

Introduction and importanceSplenic pseudocysts are extremely uncommon. Most of these cysts are asymptomatic and may result from previous blunt abdominal trauma. We report an interesting uncommon case of large splenic pseudocyst without history of previous abdominal trauma.Case presentationA 56 year old male patient, presented with symptoms of pain in the left side of middle back and discomfort in the left hypochondrium for few months. His physical examination was unremarkable. The abdominal Ultrasound and contrast-enhanced Computed tomography showed a large splenic cyst occupying most of the splenic parenchyma. Echinococcus multilocularis antibody test was negative. The differential diagnosis of this case included non-parasitic splenic cysts. The patient underwent elective exploratory laparoscopy which was converted to laparotomy with total splenectomy. Histopathological examination of the specimen revealed a splenic pseudocyst.Clinical discussionThe splenic cyst in this case was symptomatic due to its large size. It was hard to elicit an etiology as there was no history of abdominal trauma, infection, or degenerative disease. The main factors in selecting either conservative or radical surgical approach for such cases are the cyst location, cyst size, and the residual splenic parenchyma.ConclusionThe goal of splenic pseudocysts treatment is to relieve symptoms and avoid complications. Partial splenectomy is the recommended procedure when the size and location of the cyst allow preservation of at least 25% of splenic parenchyma. Otherwise, Total splenectomy is unavoidable.

Substantiation of organ-preserving surgical treatment of children with nonparasitic spleen cysts

BACKGROUND: The urgency of surgical treatment of children with nonparasitic spleen cysts is determined by the lack of consensus in the professional community, lack of regulatory documents governing the treatment of these patients, frequency of postoperative complications, and unfavorable outcomes.
 AIM: This study aimed to improve the efficiency and safety of organ-preserving minimally invasive interventions in children with nonparasitic spleen cysts based on the development of a multifactorial preoperative planning system and substantiation of an algorithm for choosing the optimal surgical strategies.
 MATERIALS AND METHODS: Results of surgical treatment of 60 children aged 218 yrs with nonparasitic spleen cysts are presented. The spleen cyst volume varied from 3 ml to 1000 ml (Me 50 ml). Preoperative examination included clinical examination, laboratory diagnostics, ultrasonography, computed tomography or magnetic resonance imaging, and angiography of the spleen vessels. The range of surgical technologies included percutaneous puncture (n = 2) and percutaneous puncture drainage (n = 28), followed by sclerosing of the cyst with 96% ethyl alcohol, combined interventions, supplemented by superselective embolization of the spleen arteries feeding the pathological formation (n = 15), laparoscopic fenestrations of cysts with physical de-epithelialization of the inner lining (n = 14), and laparoscopic resection of the spleen pole (n = 1).
 RESULTS: The analysis of postoperative complications was carried out depending on the chosen technology of surgical treatment. The follow-up period of 44 patients varied from 6 mon to 3 yrs, which made it possible to reveal the regularities of the reduction of residual cyst cavities and the course of the regeneration processes with an objective assessment of the volumetric characteristics of the spleen. Obliteration of the residual cyst cavities was observed in 79.1% of the patients during the first month after surgery. Subsequent total obliteration of the residual cyst cavities was observed within 1 yr after surgery in 91.7% of children and residual pathological formations persisted in five patients, which accounted for 8.3% of clinical observations. The volume of residual cysts ranged from 1.2% to 10.0% of the initial value, which was regarded as a satisfactory treatment result.
 CONCLUSION: Results of a retrospective multivariate analysis made it possible to develop an algorithm for substantiating surgical techniques, providing a radical cure for 95.5% of children with nonparasitic spleen cysts.

Current status and progress in the treatment of congenital liver cyst

Liver cyst is a relatively common benign liver disease. According to the cause of the disease, it can be divided into two types: non-parasitic liver cyst and parasitic liver cyst. Congenital liver cyst is the most common non-parasitic liver cyst in clinical practice, also known as true cyst, which mainly include simple liver cyst and polycystic liver diseases (PLD). In recent years, with the popularization of ultrasound and other examinations, the detection rate of liver cyst has increased year by year, but there is no unified consensus on the treatment of liver cysts. This article reviews the conservative treatment, puncture drainage, aspiration sclerotherapy, surgical treatment and other treatment options for congenital liver cysts, as well as the technological progress in recent years.

RADIAL DIGNOSTICS OF LIQUID FOCAL LIVER FORMATIONS WITH THEIR IDENTIFICATION OF A COMMUNICATIONS WITH THE INTRAHEPATIC BILIARY DUCTS

Summary. The aim of the study is to improve radiological diagnosis and differential diagnosis of fluid focal formations of the liver and their communication with the intrahepatic bile ducts.
 Materials and methods. The article presents the results of radial diagnostics of drained liquid focal liver formations (non-parasitic cyst, hydatid cyst, abscess) in 182 patients over the past 8 years. Clinical laboratory methods, sonography, computer tomography, magnetic resonance imaging, laparoscopy, cytological and bacteriological examination of liquid from a cyst or liver abscess (in various combinations), statistical methods were used for the diagnostics.
 Results and discussion. 5 modified diagnostic methods have been applied, which made it possible to improve its accuracy and, at an early stage, to identify the communication of liquid formation with the intrahepatic biliary ducts. The characteristic radial criteria that correspond to various liquid focal liver formations are given.
 Conclusions. The use of a combination of imaging methods (MSCT, MRT, et al.) is necessary in difficult cases for the detection and differential diagnosis of fluid focal formations of the liver.

ЛАПАРОСКОПИЧЕСКОЕ ЛЕЧЕНИЕ ВРОЖДЕННЫХ НЕПАРАЗИТАРНЫХ КИСТ ПЕЧЕНИ У НОВОРОЖДЕННЫХ

Congenital nonparasitic liver cysts in newborns are rare. Surgical excision of these formations is necessary to prevent complications. Reports of laparoscopic treatment of simple liver cysts in children are also rare. Authors present a series of endosurgical treatment of patients, numbering 3 children and coming from a single surgical center, and compare it with the literature data known to date. Data of 3 patients with nonparasitic liver cysts were collected at the Center for Neonatal Surgery, beginning in 2014. The analysis of the patient's demographic data and parameters of hepatic cysts (location, histological structure) is performed. Early and long-term results of laparoscopic operations were studied. All patients were newborns: 2 girls and 1 boy. The primary diagnosis was set during prenatal ultrasound examination. In all patients a complete resection of pathological liver formations was performed using laparoscopy. There were no complications during early postoperative period. In the long-term follow-up period, there were no disease recurrences. The study presents one of the largest series of laparoscopic excision of nonparasitic liver cysts in newborns. The study revealed that laparoscopy is a safe and effective method of treating of congenital hepatic cysts.

Treatment of splenic cysts

: Splenic cysts are a relatively rare entity with variable etiology. They are typically classified as primary or secondary cysts, and primary cysts are divided into parasitic and non-parasitic cysts. Parasitic cysts are typically caused by Echinococcus granulosis or multilocularis. Secondary cysts lack an epithelial lining and are therefore considered psuedocysts. They are frequently discovered incidentally and otherwise typically present with symptoms related to mass effect of the cyst. The management is greatly dependent upon size and symptomatology. Cysts that are parasitic, large, or symptomatic require operative intervention. Cysts that present with rupture or infection also require operative intervention. Laparoscopic surgery is safe and effective in surgical management of splenic cysts, and spleen preservation is preferable whenever it is possible, though splenectomy vaccines should be given if spleen preservation seems unlikely. There are a variety of techniques in operative management of splenic cysts. They can be managed by partial splenectomy, decapsulation, cyst fenestration, or unroofing of the cyst. The other technique that can be used in patients who are of prohibitive surgical risk is “PAIR” which stands for Puncture of cyst, Aspiration of cyst contents, Injection to sterilize the cyst, and Re-aspiration. This has a greater recurrence rate as does any technique that leaves any remaining cyst wall behind.

Successful treatment for intra-abdominal bleeding due to spontaneous rupture of huge liver cyst using transcatheter arterial embolization: a case report

Background: Non-parasitic simple liver cysts are one of the most common benign hepatic lesions. Although most liver cysts are asymptomatic and remain silent throughout the patient’s life, extremely large cysts can become symptomatic by direct compression to adjacent organs. Herein, we report a case of a spontaneously ruptured simple liver cyst, which is a rare presentation of a benign liver cyst. The patient’s liver cyst re-ruptured and was treated with transcatheter arterial embolization (TAE). Case report: A 62-year-old man presented to our hospital complaining of acute-onset lower abdominal pain. He had undergone laparoscopic fenestration of a huge liver cyst in another hospital 2 years prior. Computed tomography (CT) scan showed spontaneous rupture of a large liver cyst. Laparoscopic exploratory laparotomy showed no signs of ongoing intra-abdominal bleeding from the liver cyst; therefore, the operation was completed with peritoneal lavage. The patient was discharged from our hospital on postoperative day 5. Twelve days after the initial presentation, the patient was re-admitted to our hospital complaining of recurrence of lower abdominal pain. CT scan showed an enlargement of the previously ruptured liver cyst, with intra-abdominal bleeding and massive hematoma in the cyst. Extravasation of the cyst’s wall was also detected. Under the diagnosis of intra-abdominal bleeding from the artery in the wall of the huge cyst, emergent TAE was performed. Although the exact spot of extravasation was not detected, the anterior segment branch of the right hepatic artery, which corresponds to extravasation shown on the CT scan, was embolized. The patient was discharged from our hospital after 7 days, and the liver cyst remained stable without abdominal pain for more than 2 months. Conclusions: This case highlights a rare presentation of spontaneous rupture of a liver cyst with massive bleeding and the efficacy of TAE for the conservative treatment of ruptured liver cysts.

The possibility of endovideosurgery treatment of the nonparasitic liver cysts

The possibility of endovideosurgery treatment of the nonparasitic liver cysts

Laparoscopic Management of Congenital Splenic Cyst with Intracystic Bleed

Splenic cysts can be congenital, vascular, neoplastic, inflammatory, and posttraumatic contributing to 30%–40% of the total splenic lesions.Congenital splenic cysts are usually asymptomatic and are rarely seen in routine surgical practice. Due to lack of typical clinical presentation, they are discovered incidentally. Splenic congenital cysts constitute approximately 10% of total cysts. Primary (true) cysts make up approximately 20% of all types of cysts which occur in spleen. Epidermoid cysts are the rarest, which comprise only 10% of benign, nonparasitic cysts which occur in the spleen. Here, we present a case of 28-year-old female who presented to the hospital with vague upper abdominal pain and on clinical and radiological investigations was diagnosed as a case of congenital epidermoid cyst of the spleen with evidence of intracystic bleed which was managed laparoscopically.

Systematic review of laparoscopic fenestration and percutaneous sclerotherapy in the management of symptomatic nonparasitic simple liver cysts

Systematic review of laparoscopic fenestration and percutaneous sclerotherapy in the management of symptomatic nonparasitic simple liver cysts

S3434 Gastric Compression Due to Splenic Cyst

INTRODUCTION: Splenic cyst have a very low overall incidence of 0.07% out of which 0.5% across the splenectomy patient population and a further 0.08% diagnosed at autopsy. The primary epithelial cysts account for 10% of all splenic cysts. CASE DESCRIPTION/METHODS: 25 year old Caucasian female no past medical history complains of epigastric and left upper abdominal pain associated with nausea, multiple episodes of post-prandial vomiting and diarrhea for 3 weeks. CT abdomen suggested cystic splenic mass 10.1 cm in the anterior portion most likely a splenic epithelial cyst or splenic pseudocyst that was compressing the stomach. Further studies of Echinococcosis IgG, CMB/ EBV, stool ova & parasite, AFB serologies were negative, Interventional radiology performed fine needle aspiration with pig tail catheter placement. Cultures of the aspirate was positive for Enterococcus Casseliflavus, Staph. Xylosus and Enterobaccter cloacae and was treated with antibiotics. Upon resolution of the size of the cyst, stomach was distended and patient was able to tolerate PO diet. Due to persistent drainage, patient underwent cyst sclerotherapy without complication with good outcome. DISCUSSION: Splenic Cysts are asymptomatic in 30% to 60% of patients and most are diagnosed incidentally. Small (8 cm) are more likely to produce symptoms.They are Type I primary or “true” cysts and Type II secondary splenic cysts or pseudocysts. Type I splenic cysts re defined by the presence of an epithelial lining. They include both parasitic and nonparasitic etiologies.Up to 80% of nonparasitic cysts are found in patients younger than age 20 years, suggesting a congenital origin. Parasitic cysts of the spleen are caused by Taenia echinococcus, most often E. granulosus. Earlier, total splenectomy was the treatment of choice; now, splenic preservation, including partial splenectomy, cystectomy, and cyst decapsulation is becoming more commonly used. Other treatment options include (1) drainage via radiologic guidance and (2) total splenectomy. Due to the complex presentation of the splenic cyst there is only few evidence-based management and treatment regimens. Most cysts can be treated via partial and total splenectomy however splenic conservation procedures should be the focus for the future treatment.Figure 1

THE MORPHOGENESIS OF NONPARASITIC LIVER CYSTS

As a result of the introduction of imaging research methods into clinical practice, the frequency of detection of cavities in the liver has significantly increased, among which nonparasitic cysts have not been sufficiently studied. The paper provides an overview of the most commonly used classifications of this pathology. Clinical and radiological manifestations of cysts were investigated based on the analysis of the results of computed tomography, magnetic resonance imaging and ultrasound sonography of 175 patients (109 with solitary cysts and 66 with polycystic liver). The tissues of the resected areas of 81 cysts and adjacent liver tissue were studied by histological and immune-histochemical methods. Various variants of liver cysts were identified: polycystic cysts, solitary cysts and the rarest variant - ciliated anterior-intestinal hepatic cysts. The morphological and histogenetic features of solitary and ciliated anterior-intestinal hepatic cysts, as well as changes in the liver tissue adjacent to the cavities, are described. Polycystic is characterized by the presence of cavities of various sizes, with thin connective tissue partitions and a lining of cubic or flattened epithelium. The lining of solitary cysts is represented by cubic, cylindrical, sometimes multi-row epithelium. Immature biliary structures in the form of von Meijenburg complexes, islets of hepatocytes, conglomerates of dysplastic vessels are revealed in their wall among the cells of connective tissue. Ciliated anterior-intestinal hepatic cysts contain components of the primary intestine wall - a lining of a cylindrical ciliated epithelium, a layer of loose connective tissue, a muscle layer, a connective tissue capsule. Morphological studies made it possible to establish violations of embryogenesis in various types of cysts. Ciliated anterior intestinal hepatic cysts develop from the anterior section of the primary intestine, while solitary cysts are derived from its middle section. Migration of the developing buds of bronchioles from the cranial part of the primary midgut into the hepatic diverticulum determines the presence of all components of the wall of the hollow organ - cylindrical ciliated epithelium, loose connective tissue, bundles of smooth muscle fibers. Simple solitary cysts are the result of abnormal remodeling of the embryonic ductal lamina, thus being a developmental abnormality of the middle section of the primary midgut. Morphological examination of the liver tissue adjacent to the walls of the cysts reveals hypoplasia of lobules, persistence of elements of the embryonic ductal plate in the form of cords and complexes of the biliary epithelium, foci of ductopenia, von Meijenburg complexes, and various variants of vascular dysplasia.