Mass Effect from Hepatomegaly in Polycystic Kidney Disease

Excerpt

A 66-year-old man presented with progressive lower limb edema and an elevated jugular venous pressure. He had undergone renal transplantation 14 years earlier for adult polycystic kidney disease. Serum creatinine and liver function tests were normal. Echocardiogram (Fig. 1a, online video) showed normal left ventricular function (ejection fraction 68 %) but compression of the right atrium (RA) adjacent to the right ventricle (RV) by hepatic cysts (HC). Computed tomography (CT) scan confirmed compression of the right atrium (Fig. 1b) and inferior vena cava (IVC) by an enlarged liver with numerous cysts (Fig. 1c). Hepatic transplantation was considered, but the patient’s clinical condition deteriorated rapidly and he died before this could be pursued.

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