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Journal of Gastrointestinal Surgery

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01-09-2012 | Review Article

Hemorrhagic Hepatic Cyst: Report of a Case and Review of the Literature with Emphasis on Clinical Approach and Management

Authors: Zhi Ven Fong, Andrea M Wolf, Cataldo Doria, Adam C Berger, Ernest L Rosato, Francesco Palazzo

Published in: Journal of Gastrointestinal Surgery | Issue 9/2012

Abstract

Objective

Hemorrhage within a hepatic cyst (hemorrhagic hepatic cyst, HHC) is a complication of liver cysts that is difficult to differentiate from other neoplastic entities on imaging. Even when accurately diagnosed, there has been a lack of consensus on the optimal treatment strategy. After presenting our experience with a patient treated via laparoscopy, we aimed to conduct a review of the literature on HHCs.

Methods

A computerized search in Medline, PubMed, Google Scholar, and The Cochrane Collaboration was carried out for journal articles or abstracts published from 1950 to 2011.

Results

A total of 24 patients with HHCs were identified from 1983 to 2011. The cohort had an even gender distribution with a mean age of 62.7 years. Most patients presented with abdominal pain (80 %), while three (14 %) patients were asymptomatic at the time of presentation. CT imaging and ultrasound were unable to accurately diagnose HHC, whereas hyperintensity on MRI was a reliable diagnostic tool. Three (13 %) patients were managed conservatively with observation. Seven (30 %) patients had percutaneous transhepatic drainage. Among these, two patients experienced recurrence that required repeat treatment. Two (9 %) patients underwent open unroofing of their HHC and one (4 %) laparoscopically, without recurrences. Seven (30 %) patients underwent hepatic resection, whereas six (26 %) patients had a cyst enucleation for their HHCs. All patients had uneventful recoveries, with a mean follow-up of 25 months.

Conclusions

MRI is a reliable diagnostic tool in the setting of an HHC. Laparoscopic unroofing of HHCs may represent a less morbid and safe treatment modality with low recurrence rates. Given the low level of clinical evidence available so far, these results should be interpreted with caution.

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Title: Hemorrhagic Hepatic Cyst: Report of a Case and Review of the Literature with Emphasis on Clinical Approach and Management
Authors: Zhi Ven Fong
Andrea M Wolf
Cataldo Doria
Adam C Berger
Ernest L Rosato
Francesco Palazzo
Publication date: 01-09-2012
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 9/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-012-1922-6

At a glance: The STEP trials

Springer Medicine

Hemorrhagic Hepatic Cyst: Report of a Case and Review of the Literature with Emphasis on Clinical Approach and Management

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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