A liver cyst is a "blister" on the liver. Because of the word "swollen", many people regard it as a tumor and can't sleep without eating. In fact, liver cysts are another common benign mass lesion of the liver in addition to hepatic hemangiomas.
The incidence of liver cysts in the population is about 1%. Of course, it has also been reported that the detection rate of liver cysts in non-liver disease patients who undergo CT examination is as high as 18%. Usually women are more common, with a male-to-female ratio of about 2:3. With age, there is a tendency for liver cysts to increase. The ** of liver cysts may be related to abnormal development of the hepatic bile duct epithelium. As a result, few liver cysts communicate with the bile ducts.
More than 90% of patients with liver cysts are asymptomatic, and less than 10% of the remaining patients have occasional symptoms caused by compression of large liver cysts, including jaundice due to bile duct compression and abdominal distension, discomfort or pain due to compression of surrounding organs.
Symptoms such as abdominal pain, fever, and shock may occur if the cyst ruptures, bleeds, becomes infected, or, rarely, if a pedunculated liver cyst forms pedicle torsion. Sometimes there is a large liver cyst located in one lobe of the liver, which shrinks due to compression, while the other lobe of the liver is compensated. Most symptomatic patients are women over 50 years of age, and cysts are usually larger than 5 cm in diameter.
The diagnosis of liver cysts is relatively easy and can be made with ordinary ultrasound. Typical ultrasound appears that the liver is round or oval anechoic areas, some of which can be separated within the capsule; If there is intracystic hemorrhage, infection, etc., there may be hyperechoic light spots in the cyst fluid, and even bubbles may be in the cyst fluid, which should be comprehensively judged according to the patient's clinical symptoms. The differential diagnosis is to rule out polycystic liver, hepatic echinococcosis, hepatic mucinous cystadenoma, etc.
In some patients, liver cysts can become infected within the capsule. Once a liver cyst is infected, antibiotics alone fail up to 70%. Finally, these patients require puncture drainage or surgical drainage. Even if antibiotics alone** can control the infection, cyst infections are prone to recurrence shortly after surgery, and most patients eventually die from cyst infections.
The ** of liver cysts includes percutaneous aspiration, sclerotherapy injection, cyst fenestration, and cystectomy. Generally speaking, the effect of simple attraction ** is not good, and attraction-combined hardener ** is often used.
The injected hardener can be anhydrous alcohol or polyethylene glycol. Before sclerosis**, it is necessary to rule out whether the liver cyst is connected to the bile ducts. If so, one possible consequence of hardening** is intrahepatic bile duct sclerosis. If percutaneous aspiration plus sclerotherapy does not resolve the liver cyst after 2-3 attempts, surgery is required.