Intestinal obstruction due to giant liver cyst: A case report

Abstract

Background: Congenital hepatic cysts are relatively rare but are now diagnosed earlier and more frequently with a routine prenatal ultrasound. Solitary liver cysts are divided into simple and solitary intrahepatic biliary cysts, depending on the biliary connection. While some solitary liver cysts are symptomatic in childhood, even in newborns, they are often found incidentally in adults.

Case summary: A 3-mo-old female infant was admitted to Mogadishu Somali Training and Research Hospital with recurrent vomiting, respiratory problems, and abdominal bloating complaints. On examination, the abdomen was greatly distended and extremely tight. She had repeated vomiting for 3 d, no stool output, and decreased urine. The abdominal ultrasonography detected a solitary cystic lesion measuring 10 cm × 10 cm × 14 cm, extending from the liver or right kidney to the pelvis. In the magnetic resonance imaging examination of the patient, a solitary cystic structure of 10 cm × 10 cm × 14 cm in the right abdomen was observed, extending to the pelvis and possibly originating from the liver. The patient was operated via fenestration after her fluid and electrolytes improved. Oral nutrition was initiated on the 2^nd postoperative day, and the drain was removed on the 5^th postoperative day. The patient visited the outpatient clinic control 1 mo later with no clinical complaints.

Conclusion: Congenital liver cysts are usually followed without complications. They rarely reach gigantic dimensions and may cause respiratory distress, intestinal obstruction and recurrent vomiting. Surgery can provide quite successful outcomes in the treatment of giant sized simple liver cysts.

Keywords: Case report; Congenital liver cyst; Fenestration; Intestinal obstruction; Pain; Simple liver cyst.

Figure 1

Examination of physical and X-ray. A: Distension of the abdomen was apparent on physical examination; B: Direct abdominal X-ray.

Figure 2

A solitary cystic structure of 10 cm × 10 cm × 14 cm was observed by magnetic resonance imaging in the right abdomen, extending to the pelvis and possibly originating from the liver. A: Axial image; B: Coronal image.

Figure 3

Removal of the cyst adhesions without damaging the vascular structures. A: Gross appearance of the liver cyst; B: Perioperative view of the excision of the cyst wall.